Self-rated everyday and prospective memory abilities of cigarette smokers and non-smokers: a web-based study

Translation, cross-cultural adaptation, and validation of the Persian version of Everyday Memory Questionnaire-Revised (EMQ-R) in patients with multiple sclerosis

PURPOSE

The present research translated and validated the Persian version of the Everyday Memory Questionnaire-Revised (EMQ-R) in patients with multiple sclerosis (MS).

METHODS

A two-step study was performed in the current work. First, the scale was translated and culturally adopted to Persian. In the second step, the translated questionnaire was presented to 150 patients with MS and 50 individuals in the control group. Then, construct validity (factor analysis and clinical validity) and reliability measures (test-retest reliability and internal consistency) were computed for this questionnaire.

RESULTS

Patients with MS obtained higher scores in EMQ-R than the control group (p < .001). The findings of the Kaiser-Meyer-Olkin and Bartlett test approved the sampling adequacy for computing the factor analysis (p < .001). The accuracy of the three-dimensional structure was confirmed by confirmatory factor analysis (CFA). Findings of test-retest (ICC = .95, 95%CI .91-.98, p < .001) and internal consistency revealed a satisfactory value (α = .95, p < .001).

CONCLUSIONS

Satisfactory findings for construct validity and high values for reliability revealed that the Persian version of EMQ-R is a reliable and valid scale to measure the everyday memory of patients with MS in the cognitive assessments of this group.IMPLICATIONS FOR REHABILITATIONPersian EMQ-R is a valid, reliable, fast, and easy to administer tool for evaluating the beliefs and insights of patients suffering from MS or other clinical conditions about their cognitive dysfunctions, in day-to-day lives with some differentiation between memory and attentional difficulties. This questionnaire can be a practical clinical tool for the assessment of the cognitive deficits, which might not be detected via formal neuropsychological assessments, and could be a valuable scale to measure the effects of treatment approaches to level up memory function in a way that could be generalized to daily life performance.

Heightened risk of posttraumatic stress disorder in adults with autism spectrum disorder: The role of cumulative trauma and memory deficits

BACKGROUND

Individuals with Autism Spectrum Disorder (ASD) are known to be at increased risk of exposure to traumas such as maltreatment and abuse, however less is known about possible susceptibility towards the development of Posttraumatic Stress Disorder (PTSD) and associated risk factors.

AIMS

This study investigated the rates of trauma exposure and PTSD, and the role of cumulative trauma exposure and memory as risk factors for PTSD in adults who self-reported having received an ASD diagnosis, compared to a typically developing (TD) comparison group.

METHODS

Questionnaires assessing self-reported frequency of trauma exposure (LEC), PTSD symptomology (PCL-S) and memory (EMQ- R and BRIEF-A) were completed online by 38 ASD adults and 44 TD adults.

RESULTS

Rates of trauma exposure and PTSD symptomatology were significantly higher in the ASD group, compared to the TD group, with deficits in working memory and everyday memory mediating this association. Interestingly, a cumulative effect of trauma exposure on PTSD symptom severity was only found in the ASD group.

CONCLUSIONS

High rates of trauma and probable PTSD in ASD adults highlight the importance of routine screening. Cumulative trauma exposure and memory deficits may act to increase risk of PTSD in ASD; longitudinal research is called for.

How did I remember to do that? Self-reported strategy use for laboratory prospective memory tasks

The role of metacognition in prospective memory (PM) has received relatively little attention. This study combined data from several experiments to identify the strategy repertoire employed during a classic laboratory PM task and to determine whether self-reported strategy was related to performance. Participants (N = 668) completed either a focal or nonfocal PM task embedded in an ongoing lexical decision task. The results indicated that participants reported the same strategy repertoire regardless of PM task focality. Participants who reported using a strategy performed better than those who did not report using one, and this was especially true under nonfocal conditions. Self-reported strategy use was also associated with more cost to the ongoing task when the opportunity to complete the PM task was present. These findings add to what is known about the metacognitive components of PM and underscore the need for additional research in this area.

Quantification of Trace Elements in Different Dokha and Shisha Tobacco Products using EDXRF

The present study aims to quantify trace metals in different dokha (medwakh) and shisha tobacco products available in local markets. Recent research has shown that these products have higher amounts of nicotine and tar compared to various other tobacco products. No specific data are available on the concentration of trace elements in dokha (medwakh) and shisha tobacco products in the Middle East and North Africa (MENA) region. Harmful health effects due to the toxicity of these elements in tobacco and its smoke have not been adequately emphasized. Concentrations of trace elements were extensively studied using HORIBA XGT-7200 EDXRF fluorescence absorption spectroscopy. The mean concentrations of aluminum, calcium, chromium, copper, iron, magnesium, manganese, nickel, potassium, strontium and zinc in 13 dokha products in μg/g were 406.92 ± 41.72, 14703.27 ± 271.73, 11.73 ± 2.12, 25.58 ± 2.63, 753.85 ± 14.87, 5306.54 ± 134.94, 82.31 ± 4.55, 25.58 ± 2.50, 2212.12 ± 39.04, 816.92 ± 15.26 and 35.96 ± 2.63, respectively; and those in the three shisha products in μg/g were 244.83 ± 25.11, 8235.77 ± 144.51, 3.40 ± 0.38, 22.77 ± 4.50, 569.13 ± 10.22, 2096.20 ± 130.69, 72.13 ± 7.13, 27.67 ± 5.31, 4467.50 ± 168.06, 320.20 ± 6.03 and 36.40 ± 3.57, respectively. In our study, the quantified trace metal concentrations in dokha and shisha tobacco using the EDXRF method were ten times higher than the LODs. The percentage of RSD was <10%, validating the precision of the method. Tobacco smoking is a major source of consumption of toxic elements, not only in the smoker but also in non-smokers through passive smoking. In dokha (medwakh) and shisha tobacco products, compared with cigarettes, Ni levels were significantly higher, Cr, Cu and Zn levels were higher, and Fe levels were similar, while Al and Mn levels were lower. The dokha and shisha tobacco products have no filters; many toxic metals can quickly enter the lungs and cause different pulmonary diseases and oral infections. Tobacco smoking causes lung and oral cancers, chronic obstructive pulmonary disease and cardiovascular diseases.

Mood Fluctuation and Psychobiological Instability: The Same Core Functions Are Disrupted by Novel Psychoactive Substances and Established Recreational Drugs

Many novel psychoactive substances (NPS) have entered the recreational drug scene in recent years, yet the problems they cause are similar to those found with established drugs. This article will debate the psychobiological effects of these newer and more traditional substances. It will show how they disrupt the same core psychobiological functions, so damaging well-being in similar ways. Every psychoactive drug causes mood states to fluctuate. Users feel better on-drug, then feel worse off-drug. The strength of these mood fluctuations is closely related to their addiction potential. Cyclical changes can occur with many other core psychobiological functions, such as information processing and psychomotor speed. Hence the list of drug-related impairments can include: homeostatic imbalance, HPA axis disruption, increased stress, altered sleep patterns, neurohormonal changes, modified brain rhythms, neurocognitive impairments, and greater psychiatric vulnerability. Similar patterns of deficit are found with older drugs such as cocaine, nicotine and cannabis, and newer substances such as 3,4-methylenedioxymethamphetamine (MDMA), mephedrone and spice. All psychoactive drugs damage human well-being through similar basic neuropsychobiological mechanisms.

Adults with developmental dyslexia show selective impairments in time-based and self-initiated prospective memory: Self-report and clinical evidence

BACKGROUND

Prospective memory (PM; memory for delayed intentions) would seem to be impaired in dyslexia but evidence is currently limited in scope.

AIMS

There is a need, therefore, firstly, to explore PM under controlled conditions using a broader range of PM tasks than used previously and, secondly, to determine whether objectively measured and self-reported PM problems can be found in the same individuals with dyslexia.

METHODS AND PROCEDURES

The responses of 30 adults with dyslexia were compared with those of 30 IQ-matched adults without dyslexia on a self-report and a clinical measure of PM.

OUTCOMES AND RESULTS

Dyslexia-related deficits were shown on the clinical measure overall and, more particularly, when PM responses had to be made to cues based on time rather than environmental events. Adults with dyslexia were also more likely to forget to carry out an intention under naturalistic conditions 24h later. On the self-report questionnaire, the group with dyslexia reported significantly more frequent problems with PM overall, despite using more techniques to aid their memory. In particular, problems were identified with longer-term PM tasks and PM which had to be self-initiated.

CONCLUSIONS AND IMPLICATIONS

Dyslexia-related PM deficits were found under both laboratory and everyday conditions in the same participants; the first time that this has been demonstrated. These findings support previous experimental research which has highlighted dyslexia-related deficits in PM when the enacting of intentions is based on time cues and/or has to be self-initiated rather than being in prompted by environmental events.

Cigarette smoke and related risk factors in neurological disorders: An update

Cigarette smoking is known to be harmful to health, and is considered the main cause of death worldwide, especially in India. Among the well-distinguished diseases related to smoking are, chronic obstructive pulmonary disease, oral and peripheral cancers, and cardiovascular complications. However, the impact of cigarette smoking on neurocognitive and neuropathological effects, including anxiety, Alzheimer's disease, Parkinson's disease, ischemic stroke, and blood-brain barrier dysfunction, still remains unclear. Cigarette smoke consists of more than 4500 toxic chemicals that combine to form free radicals, which lead to oxidative stress-associated neurological disorders. Herein, we discuss the role of antioxidant agents in delaying or attenuating disease complications. In addition, in this review, we discuss the neuropathological effect of cigarette smoke and its interference in neurodegeneration.

Chronic obstructive pulmonary disease and cognitive impairment in the Chinese elderly population: a large national survey

Background

Previous studies suggested an association between chronic obstructive pulmonary disease (COPD) and cognitive impairment, mostly in developed countries. There is no evidence available on the association between these two common chronic disorders in the elderly people in People’s Republic of China where the population is aging rapidly.

Methods

The study population was randomly selected from a nationally representative Disease Surveillance Point System in People’s Republic of China. A standardized questionnaire was administered by trained interviewers during a face-to-face interview in the field survey conducted in 2010–2011. Cognitive function was assessed using the Mini-Mental State Examination. COPD was measured by self-report and the Medical Research Council respiratory questionnaire was used to assess respiratory symptoms. A multivariate logistic regression model was applied to examine the association between COPD and cognitive impairment with adjustment for potential confounding factors.

Results

A total of 16,629 subjects aged over 60 years were included in the study. The prevalence of cognitive impairment was 9.4% (95% confidence interval [CI] 7.7, 11.1). Chronic phlegm was associated with significantly higher prevalence of cognitive impairment in models adjusted for age, sex, marital status, geographic region, urban/rural, education, smoking status, alcohol drinking, and indoor air pollution (odds ratio [OR] 1.46, 95% CI 1.11, 1.93). Chronic respiratory symptoms and self-reported COPD were strongly related to cognitive impairment in urban areas. There were no significant effect modifications for sex, regions, educational level, smoking status, and alcohol drinking.

Conclusion

There was strong association between COPD and cognitive impairment in urban Chinese elderly population.

Why all stimulant drugs are damaging to recreational users: an empirical overview and psychobiological explanation

AIMS

Stimulant drugs such as nicotine and Ecstasy/3, 4-methylenedioxymethamphetamine (MDMA) are taken for positive reasons, yet their regular use leads to deficits rather than gains. This article outlines the psychobiological rationale for this paradox.

METHODS

The empirical literature on nicotine, cocaine, amphetamine, Ecstasy/MDMA, and mephedrone are reviewed. A theoretical explanation for why they are problematic to humans is then described.

RESULTS

The acute effects of central nervous system (CNS) stimulants are typically positive, with greater alertness and emotional intensity. However, in the post-drug recovery period, the opposite feelings develop, with lethargy and low moods. All recreational stimulants cause mood fluctuation, although it is most pronounced in drugs with rapid onset and comedown (e.g. nicotine and cocaine), explaining why they are the most addictive. Parallel fluctuations occur across many psychological and neurocognitive functions, with users suffering various off-drug deficits. CNS stimulants also affect the hypothalamic-pituitary-adrenal axis, impairing sleep, disrupting homeostasis, and exacerbating psychiatric distress. Neuroimaging studies reveal altered brain activity patterns in regular users. These problems are related to lifetime usage but commence in novice users.

CONCLUSIONS

Repetitive CNS stimulation is potentially damaging to the organism, both acutely and chronically. The review describes the various psychobiological systems through which recreational stimulant drugs impair human well-being.

Cognitive functioning in obstructive lung disease: results from the United Kingdom biobank

OBJECTIVES

To compare domains of cognitive functioning between persons with and without obstructive lung disease (OLD) and to analyze the relationship between cognitive functioning and the degree of airflow limitation.

DESIGN

An observational population-based study.

SETTING

This research was conducted using the United Kingdom Biobank Resource.

PARTICIPANTS

The study population consisted of 43,039 persons with complete data on cognitive functioning and spirometry.

MEASUREMENTS

Cognitive functioning was compared between persons with and without OLD using linear regression analysis. The relationship between impairment in lung function and cognitive impairment was assessed among persons with OLD.

RESULTS

Persons with OLD had significantly worse scores than persons without OLD on prospective memory [β = -0.15 (-0.22 to -0.09)], visuospatial memory [β round 1 = 0.06 (0.03‒0.10)]; β round 2 = 0.09 (<0.001‒0.18)), numeric short-term memory [β = ‒0.05 (‒0.10 to <0.001)] and cognitive processing speed [β = 4.62 (1.25‒8.01)] after correction for possible confounders. Impairment in prospective memory [β = 0.004 (<0.001‒0.01)] and numeric short-term memory [β = 0.01 (0.003‒0.01)] were weakly related to FEV1 (adjusted P < .05).

CONCLUSIONS

Persons with OLD experience cognitive impairment in different domains, which is partially related to airway obstruction. In particular, memory and information processing are affected. Further assessment of the relationship with patient-related outcomes is needed to optimize patient-oriented treatment.

Nicotine derived from the electronic cigarette improves time-based prospective memory in abstinent smokers

RATIONALE

It is well established that nicotine improves, and deprivation impairs, cognitive performance and mood in smokers. Prospective memory (PM), remembering to execute a delayed intention at a given time point, is under-explored in smokers. Whilst a handful of studies have shown improved PM with nicotine, the effects of nicotine delivered via the electronic cigarette (e-cigarette) have not been investigated.

OBJECTIVE

This study explores whether, by comparison with placebo, nicotine delivered via the e-cigarette can improve PM, tobacco withdrawal symptoms and desire to smoke in abstinent smokers.

METHODS

Twenty smokers, abstinent for 8-10 h, each completed two experimental sessions under nicotine (18 mg) and placebo (0 mg) e-cigarette conditions. Participants completed a single-item desire-to-smoke scale and the Mood and Physical Symptoms Scale. PM was measured using the Cambridge Prospective Memory Test.

RESULTS

Compared with placebo, the nicotine e-cigarette reduced the desire to smoke and tobacco withdrawal symptoms, and improved time-based but not event-based PM. There was a moderate, marginally significant negative correlation between PM performance during abstinence and nicotine dependence.

CONCLUSIONS

This is the first study to show that nicotine derived via e-cigarette can improve PM in abstinent smokers, suggesting efficient nicotine delivery. The finding that the effect of nicotine was restricted to time-based rather than event-based PM is consistent with the view that nicotine acts to improve performance on strategic (effortful) rather than automatic processing. These findings add to the growing body of evidence that the e-cigarette can replace some of the effects of nicotine derived from tobacco smoking, thus highlighting its potential for smoking cessation.

Smoking-related prospective memory deficits observed on naturalistic everyday memory task

OBJECTIVE

This study assessed self-reported and objective prospective memory (PM) processes in smokers and a never-smoked comparison group. If persistent smoking does impair PM, then one would expect smokers recall being lower on a study that requires them to remember everyday activities when compared with a never-smoked group.

METHOD

An existing-groups design was used to compare a group of smokers with a never-smoked group on the self-report Prospective Memory Questionnaire (PMQ) and the Prospective Remembering Video Procedure (PRVP) measuring objective PM. An example of the location-action combination from the PRVP is 'At Thornton's shop' (location), 'Buy a bag of sweets' (action). Participants who reported using an illegal substance (e.g. ecstasy, cannabis), who drank excessively or were 'binge drinkers', or who reported suffering from a clinical condition, such as depression, were excluded from the study. Age, weekly 'safe levels' alcohol use, and strategy use were also measured and controlled for in the study. Each person was tested individually in a quiet laboratory setting on a university campus.

RESULTS

After controlling for variations in age, weekly alcohol use, and strategy use, smokers recalled significantly fewer location-action combinations on the PRVP when compared with a never-smoked group, with no between-group differences on self-reported PM as measured by the PMQ.

CONCLUSIONS

The findings suggest objective PM deficits are associated with persistent smoking - a relatively unexplored area of research. This cannot be attributed to other drug use, mood, or strategy use. The findings also suggest smokers lack self-awareness of such PM deficits. This study extends the area by utilising a more naturalistic object measure of PM and incorporating strict controls into the study.

The Memory Failures of Everyday (MFE) test: normative data in adults

One approach to the study of everyday memory failures is to use multiple-item questionnaires. The Memory Failures of Everyday (MFE) test is one of the most frequently used in Spain. Our objective is to provide normative data from the MFE in a sample of healthy, Spanish, adult participants for use in clinical practice. The sample consists of 647 employees at a large company ranging in age from 19-64 years-old. Everyday memory failures were evaluated by means of the MFE with the following response format: 0-2 (0 = never or rarely; 1 = occasionally, sometimes; 2 = frequently, often).

RESULTS

Mean MFE = 15.25 (SD = 7.50), range 0-40. Correlation with age: .133 (p = .001); and with years of education: - .059 (n.s.). A constant increase in MFE was not observed across age groups (F = 4, 59; p = .003, eta2 = .02), but differences were revealed between the 19-29 and 40-49 age groups; no differences were observed between the remaining age groups. Only slight differences between men and women occurred, the women's mean being slightly higher than the men's, but the confidence intervals overlapped (F = 5, 71; p = .017, eta2 = .01). These results indicate that age, years of education, and sex had no significant effects. In light of the above, the sample was viewed as a whole when computing the percentiles reported here.

Smoking-related prospective memory deficits in a real-world task

BACKGROUND

Smokers, previous smokers and a never smoked group were compared on self-reported and real world prospective memory (PM - the cognitive ability of remembering to carry out particular actions at some future point in time).

METHODS

Twenty-seven current smokers, 24 people who had never smoked and 18 previous smokers were compared using an existing groups design. Scores on the long and short term PM subscales of the Prospective and Retrospective Memory Questionnaire (PRMQ) and scores on a Real World Prospective Memory Task (RWPMT) constituted the dependent measures. Smoking and other drug use were assessed by a Recreational Drug Use Questionnaire. The Hospital Anxiety and Depression Scale gauged levels of anxiety and depression. The National Adult Reading Test measured IQ, and retrospective memory was measured using the PRMQ. Gender, age, anxiety and depression, IQ, alcohol use and the retrospective memory scores, were measured as covariates and controlled for in the analysis.

RESULTS

A series of univariate ANCOVAs were applied to the main PM data across the three groups, controlling for variations in age, gender, mood, IQ, alcohol use and retrospective memory scores. These revealed no significant between-group differences on self-reported PM; however smokers recalled significantly fewer action-location combinations than the never smoked and previous smoker groups on the objective RWPMT.

CONCLUSIONS

Existing smokers showed reduced performance on RWPMT when compared to the never smoked group and previous smokers. Real-world PM impairments should be added to a growing list of neuropsychological sequelae associated with persistent smoking.

Executive function profile in the offspring of women that smoked during pregnancy

INTRODUCTION

Smoking tobacco during pregnancy results in exposure to the fetal neuroteratogen nicotine. The current study evaluated if the offspring of smokers show abnormalities in maternal ratings of executive function, prevalence of Attention Deficit Hyperactivity Disorder (ADHD), and academic performance. A secondary objective was to determine the utility of online data collection.

METHODS

Mothers (N = 357) completed the parent form of the Behavioral Rating Inventory of Executive Function (BRIEF) and provided information about smoking during pregnancy.

RESULTS

The internal consistency of the BRIEF when administered electronically was quite satisfactory (Cronbach's α = .98). As anticipated, ADHD was more frequently diagnosed in the offspring of women that smoked at least 10 cigarettes/day (odds ratio [OR] = 2.64, 95% CI = 1.22-5.71). Higher (i.e., more problematic) ratings relative to unexposed children (p < .01) were only identified on the total BRIEF score, the Metacognition Index, and on the Initiate, Plan/Organize, and Monitor scales among children exposed to ≥10 cigarettes/day. Nicotine-exposed children were also more likely to perform less well than their classmates in math (OR = 2.78, 95% CI = 1.59-4.87) and reading (OR = 2.00, 95% CI = 1.10-3.63), and these academic effects were independent of maternal education levels.

CONCLUSIONS

This report provides preliminary evidence that the BRIEF has adequate psychometric properties when administered electronically and that mothers who smoke have offspring with lower executive function proficiency. These findings contribute to a larger literature that indicates that smoking during pregnancy results in adverse reproductive outcomes and, possibly, subtle but enduring deficits in prefrontal function.

Prospective memory in substance abusers at treatment entry: associations with education, neuropsychological functioning, and everyday memory lapses

Individuals with substance use disorders (SUDs) commonly report lapses in prospective memory (PM) in their daily lives; however, our understanding of the profile and predictors of laboratory-based PM deficits in SUDs and their associations with everyday PM failures is still very preliminary. The current study examined these important questions using well-validated measures of self-report and laboratory-based PM in a mixed cohort of 53 SUD individuals at treatment entry and 44 healthy adults. Consistent with prior research, the SUD group endorsed significantly more self-cued and environmentally based PM failures in their daily lives. Moreover, the SUD group demonstrated significantly lower time-based PM performance, driven largely by cue detection errors. The effect of SUDs on PM was particularly strong among participants with fewer years of education. Within the SUD cohort, time-based PM was correlated with clinical measures assessing executive functions, retrospective memory, and psychomotor speed. Importantly, time-based PM was uniquely associated with elevated PM failures in daily lives of the SUD participants, independent of current affective distress and other neurocognitive deficits. Findings suggest that individuals with SUD are vulnerable to deficits in PM, which may in turn increase their risk for poorer everyday functioning outcomes (e.g., treatment non-compliance).

Smoking and everyday prospective memory: a comparison of self-report and objective methodologies

AIMS

To examine whether persistent smoking leads to impairments in self-reported and objective measures of prospective memory (PM: the cognitive ability to remember to carry out activities at some future point in time).

METHODS

An opportunity sample of 18 existing smokers and 22 who had never smoked were compared. An existing-groups design was utilised, comparing a smoking group with a never-smoked control group as the independent factor. Scores on the sub-scales of the Prospective and Retrospective Memory Questionnaire (PRMQ) and scores on the Cambridge Prospective Memory Test (CAMPROMPT) constituted the dependent factors. Age, mood, other drug use, strategy scores and IQ were also measured. Each participant was tested in a laboratory setting. Self-reported PM lapses were measured using the PRMQ. The CAMPROMPT was used as an objective measure of PM. Alcohol and other drug use were assessed by a Recreational Drug Use Questionnaire. The Hospital Anxiety and Depression Scale gauged levels of anxiety and depression. A strategy scale measured the number of strategies used to aid memory. The National Adult Reading Test measured IQ.

RESULTS

After observing no between-group differences on age, mood, alcohol use, strategy use, and IQ, smokers and the never-smoked did not differ on the self-reported lapses measured on the PRMQ. However, smokers recalled significantly fewer items on the CAMPROMPT than the never-smoked group.

CONCLUSION

The results of the present study suggest that persistent smoking leads to impairments in everyday PM.

Chronic cigarette smoking: implications for neurocognition and brain neurobiology

Compared to the substantial volume of research on the general health consequences associated with chronic smoking, little research has been specifically devoted to the investigation of its effects on human neurobiology and neurocognition. This review summarizes the peer-reviewed literature on the neurocognitive and neurobiological implications of chronic cigarette smoking in cohorts that were not seeking treatment for substance use or psychiatric disorders. Studies that specifically assessed the neurocognitive or neurobiological (with emphasis on computed tomography and magnetic resonance-based neuroimaging studies) consequences of chronic smoking are highlighted. Chronic cigarette smoking appears to be associated with deficiencies in executive functions, cognitive flexibility, general intellectual abilities, learning and/or memory processing speed, and working memory. Chronic smoking is related to global brain atrophy and to structural and biochemical abnormalities in anterior frontal regions, subcortical nuclei and commissural white matter. Chronic smoking may also be associated with an increased risk for various forms of neurodegenerative diseases. The existing literature is limited by inconsistent accounting for potentially confounding biomedical and psychiatric conditions, focus on cross-sectional studies with middle aged and older adults and the absence of studies concurrently assessing neurocognitive, neurobiological and genetic factors in the same cohort. Consequently, the mechanisms promoting the neurocognitive and neurobiological abnormalities reported in chronic smokers are unclear. Longitudinal studies are needed to determine if the smoking-related neurobiological and neurocognitive abnormalities increase over time and/or show recovery with sustained smoking cessation.

Subjective ratings of prospective memory deficits in chronic alcohol users

Previous research showing everyday memory is impaired by heavy alcohol use may have underestimated the cognitive impairment of heavy users because drinkers consuming over the recommended limits for safe drinking have often been treated as a homogeneous group, often with a low threshold for inclusion. The current study investigated whether the reported linear relationship applies to participants consuming alcohol significantly above recommended limits. The everyday memory of 80 participants (43 men; modal age, 31-35 years) was investigated using the Prospective Memory Questionnaire. Participants also detailed their average weekly intake of alcohol and other substances. Current heavy users of alcohol (who consumed on average over 25 units per week) reported more memory problems than low (1-9 units per week) or medium users (10-25 units per week). Participants undergoing counselling for alcohol use reported more deficits than low or medium drinkers, but fewer than current heavy drinkers. Possible reasons for this were discussed. Strengths and limitations of subjective approaches to memory assessment were discussed as well as suggestions for future research.

Does cannabis use affect prospective memory in young adults?

The aim of the present study was to examine prospective memory impairments associated with cannabis use in young adults. An independent measures design utilising pre-existing groups of users and non-users was employed in which an opportunity sample of 90 undergraduates studying at universities in the north east of England participated. The number of prospective memory failures reported on the Prospective Memory Questionnaire and the number of location-action combinations correctly recalled during a video-based prospective memory task were measured. The number of strategies used to assist memory, level of anxiety and depression, and use of alcohol, nicotine and any other recreational drugs in addition to cannabis were also measured and controlled during the analysis. Analysis revealed no significant differences in the number of self-reported prospective memory failures; however, cannabis users recalled significantly fewer location-action combinations than non-users in the video-based prospective memory task. The findings from the present study suggest that cannabis use has a detrimental effect on prospective memory ability in young adults but users may not be aware of these deficits.

Executive function deficits in short-term abstinent cannabis users

OBJECTIVES

Few cognitive tasks are adequately sensitive to show the small decrements in performance in abstinent chronic cannabis users. In this series of three experiments we set out to demonstrate a variety of tasks that are sufficiently sensitive to show differences in visual memory, verbal memory, everyday memory and executive function between controls and cannabis users.

METHODS

A series of three studies explored cognitive function deficits in cannabis users (phonemic verbal fluency, visual recognition and immediate and delayed recall, and prospective memory) in short-term abstinent cannabis users. Participants were selected using snowball sampling, with cannabis users being compared to a standard control group and a tobacco-use control group.

RESULTS

The cannabis users, compared to both control groups, had deficits on verbal fluency, visual recognition, delayed visual recall, and short- and long-interval prospective memory. There were no differences for immediate visual recall.

CONCLUSIONS

These findings suggest that cannabis use leads to impaired executive function. Further research needs to explore the longer term impact of cannabis use.

Chronic cigarette smoking modulates injury and short-term recovery of the medial temporal lobe in alcoholics

Memory function is largely mediated by the medial temporal lobe (MTL), and its compromise has been observed in alcohol dependence and chronic cigarette smoking. The effects of heavy alcohol consumption and chronic smoking on hippocampal volumes and MTL metabolites and their recovery during abstinence from alcohol have not been assessed. Male alcoholics in treatment (ALC) [13 smokers (sALC) and 11 non-smokers (nsALC)] underwent quantitative magnetic resonance imaging and short-echo proton magnetic resonance spectroscopic imaging at 1 week and 1 month of sobriety. Outcome measures were compared with 14 age-matched, non-smoking light-drinkers and were related to visuospatial learning and memory. Over 1 month of abstinence, N-acetyl-aspartate, a neuronal marker, and membrane-associated choline-containing metabolites normalized in the MTL of nsALC subjects, but remained low in the MTL of sALC subjects. Metabolite concentration changes in both groups were associated with improvements in visuospatial memory. Hippocampal volumes increased in both groups during abstinence, but increasing volumes correlated with visuospatial memory improvements only in nsALC subjects. In summary, chronic cigarette smoking in alcohol-dependent men appears to have adverse effects on MTL metabolite recovery during short-term sobriety. These data may also have implications for other conditions with established MTL involvement and significant smoking co-morbidity, such as schizophrenia-spectrum and mood disorders.

Chronic Smoking Is Associated With Differential Neurocognitive Recovery in Abstinent Alcoholic Patients: A Preliminary Investigation

BACKGROUND

Approximately 50 to 90% of individuals in North America seeking treatment for alcoholism are chronic smokers. A growing body of evidence suggests that chronic cigarette smokers show a pattern of neurocognitive dysfunction similar to that observed in alcoholic patients. However, previous studies investigating neurocognitive recovery in abstinent alcoholic patients did not specifically consider the potential effects of chronic cigarette smoking.

METHODS

This study comprehensively compared longitudinal neurocognitive changes over 6 to 9 months of abstinence among 13 nonsmoking recovering alcoholic patients (ALC) and 12 actively smoking ALC. The neurocognitive performance of the alcoholic groups was compared with nonsmoking light-drinking controls (nonsmoking LD).

RESULTS

Nonsmoking ALC exhibited a significantly greater magnitude of longitudinal improvement than smoking ALC on measures of cognitive efficiency, executive skills, visuospatial skills, and working memory. Both nonsmoking ALC and smoking ALC demonstrated equivalent improvement on auditory-verbal learning, auditory-verbal memory, and processing speed. Nonsmoking LD showed no significant changes in neurocognition over time. In cross-sectional comparisons at 6 to 9 months of abstinence, nonsmoking ALC were superior to smoking ALC on measures of auditory-verbal learning, auditory-verbal memory, cognitive efficiency, executive skills, processing speed, and working memory. The longitudinal and cross-sectional neurocognitive differences observed between nonsmoking and smoking ALC remained significant after covarying for group differences in education, estimated premorbid intelligence alcohol consumption, and other potentially confounding variables. In smoking ALC, greater smoking severity was inversely related to longitudinal improvement on multiple neurocognitive measures.

CONCLUSIONS

These preliminary results suggest that chronic smoking may modulate neurocognitive recovery in abstinent alcoholic patients. More generally, chronic smoking may impact neurocognition in other conditions where is it a prevalent behavior.

Non-treatment-seeking heavy drinkers: effects of chronic cigarette smoking on brain structure

We previously reported [Cardenas, V.A., Studholme, C., Meyerhoff, D.J., Song, E., Weiner, M.W., 2005. Chronic active heavy drinking and family history of problem drinking modulate regional brain tissue volumes. Psychiatry Res. 138, 115-130] that non-treatment-seeking, active heavy drinkers (HD) demonstrated smaller regional neocortical gray matter volumes compared to light drinking controls; however, the potential effects of chronic cigarette smoking on regional brain volumes were not addressed. The goal of this retrospective analysis was to determine if chronic smoking affected brain structure in the non-treatment-seeking heavy drinking sample from our earlier report (i.e., Cardenas et al., 2005). Regional volumetric comparisons were made among age-matched smoking HD (n=17), non-smoking HD (n=16), and non-smoking light drinkers (nsLD; n=20) from our original sample. Quantitative volumetric measures of neocortical gray matter (GM), white matter (WM), subcortical structures, and cerebral spinal fluid (CSF) were derived from high-resolution magnetic resonance imaging. Smoking HD demonstrated smaller volumes than nsLD in the frontal, parietal, temporal GM, and for total neocortical GM. Smoking HD also demonstrated smaller temporal and total GM volumes than non-smoking HD. Non-smoking HD and nsLD did not differ significantly on GM volumes. Further, the three groups did not differ on lobar WM, subcortical structures or regional CSF volumes. These retrospective analyses indicate neocortical GM volume reductions in non-treatment-seeking smoking HD, but not in non-smoking HD, which are consistent with our studies in recently detoxified treatment-seeking alcohol-dependent samples.

Dancing hot on Ecstasy: physical activity and thermal comfort ratings are associated with the memory and other psychobiological problems reported by recreational MDMA users

BACKGROUND

Non-drug factors such as ambient temperature can heighten the adverse effects of MDMA (3,4-methylendioxymethamphetamine) in animals. We assessed whether dancing and feeling hot on Ecstasy would be associated with more psychobiological problems in recreational users.

METHODS

In an internet study, 206 unpaid participants (modal age 16-24) reported that they had used recreational Ecstasy/MDMA. They completed a drug use questionnaire, the Prospective Memory Questionnaire (PMQ), questions about dancing and feeling hot when on Ecstasy, and psychobiological problems afterwards.

RESULTS

Those who danced 'all the time' when on Ecstasy, reported significantly more PMQ memory problems than the less intensive dancers. Prolonged dancing was also associated with more complaints of depression, memory problems, concentration and organizational difficulties afterwards. Feeling hot when on Ecstasy was associated with poor concentration in the comedown period, and with mood fluctuation and impulsivity off-drug. PMQ long-term problems demonstrated a significant curvilinear relationship with thermal self-ratings; more memory problems were noted by those who felt very hot, and by those who did not feel hot when on Ecstasy.

CONCLUSIONS

Non-drug factors such as dancing and feeling hot are associated with the incidence of psychobiological problems reported by recreational Ecstasy/MDMA users.

A comparison of neurocognitive function in nonsmoking and chronically smoking short-term abstinent alcoholics

Approximately 70-90% of individuals in North America seeking treatment for alcoholism are chronic smokers. A growing body of evidence suggests chronic cigarette smoking alone adversely affects neurocognition in adults. However, few studies on the neurocognitive function of short-term abstinent alcoholics have specifically considered the potential effects of chronic cigarette smoking. In this study, 20 nonsmoking recovering alcoholics (nsRA) and 22 actively smoking recovering alcoholics (sRA) participants, matched on age and education, were contrasted on a comprehensive neurocognitive battery after 34+/-9 days of abstinence. nsRA were superior to sRA on measures of auditory-verbal learning and memory, processing speed, cognitive efficiency, and static postural stability. These group differences were not a function of group disparities in age, education, estimated premorbid verbal intelligence, lifetime alcohol consumption, or other measured comorbid psychiatric or medical factors. In sRA, longer smoking duration was negatively correlated with executive skills, visuospatial learning, general cognitive efficiency, and static postural stability. These results indicate that greater consideration of the potential neurobiological effects of current chronic smoking on neurocognitive functioning is warranted in studies of alcoholism and other conditions where smoking is a common comorbid factor.

Smoking is associated with neurocognitive deficits in alcoholism

BACKGROUND

Impaired problem solving, visual-spatial processing, memory, and cognitive proficiency are consequences of severe alcoholism. Smoking is much more prevalent among alcoholics than the general population, yet the possible neurocognitive effects of cigarette smoking in alcoholism have not been studied, despite evidence that long-term smoking is associated with neurocognitive deficits.

OBJECTIVE

Determine whether smoking contributes to neurocognitive deficits associated with alcoholism.

DESIGN

Neurocognitive function was examined in a community-recruited (n=172) sample of men. Alcohol problems/alcoholism were measured by the lifetime alcohol problems score (LAPS), DSM-IV diagnosis, and monthly drinking rate. Smoking was measured in pack-years. Neurocognitive function was measured with IQ (short version of WAIS-R), and cognitive proficiency (fast, accurate performance).

RESULTS

Both alcoholism and smoking were negatively correlated with neurocognitive function. When alcoholism and smoking were included in regression models, smoking remained a significant predictor for both measures, but alcoholism remained significant only for IQ.

CONCLUSIONS

Both smoking and alcoholism were related to neurocognitive function. Smoking may explain some of the relationship between alcoholism and neurocognitive function, perhaps especially for measures that focus on proficiency. Future studies are necessary to more fully understand the effects of smoking on neurocognitive function in alcoholism.

MDMA in humans: factors which affect the neuropsychobiological profiles of recreational ecstasy users, the integrative role of bioenergetic stress

Many recreational ecstasy/MDMA users display neuropsychobiological deficits, whereas others remain problem free. This review will investigate some of the drug and non-drug factors which influence the occurrence of these deficits. Acute and chronic MDMA usage are both important. Intensive use within a session is often associated with more problems. In term of lifetime usage, novice users generally remain unimpaired, whereas most heavy users report memory or other psychobiological problems which they attribute to ecstasy. These complaints are confirmed by objective deficits in working memory, attention, frontal-executive, and episodic memory tasks. Psychobiological deficits include disturbed sleep, sexual dysfunction, reduced immuno-competence, and increased oxidative stress. Further MDMA-related factors which may contribute to these changes, include acute and chronic tolerance, and drug dependence. Around 90ñ95% of ecstasy/MDMA users also take cannabis, and this can independently contribute to the adverse neuropsychobiological pro.les; although in some situations the acute co-use of these two drugs may be interactive rather than additive, since cannabis has relaxant and hypothermic properties. Alcohol, nicotine, amphetamine, and other drugs, can also affect the psychobiological pro.les of ecstasy polydrug users in complex ways. Pure MDMA users are rare but they have been shown to display significant neurocognitive deficits. Psychiatric aspects are debated in the context of the diathesis-stress model. Here the stressor of ecstasy polydrug drug use, interacts with various predisposition factors (genetic, neurochemical, personality), to determine the psychiatric outcome. Recreational MDMA is typically taken in hot and crowded dances/raves. Prolonged dancing, feeling hot, and raised body temperature, can also be associated with more psychobiological problems. This is consistent with the animal literature, where high ambient temperature and other metabolic stimulants boost the acute effects of MDMA, and cause greater serotonergic neurotoxicity. In conclusion, the neuropsychobiological effects of MDMA are modulated by a wide range of drug and non-drug factors. These multiple influences are integrated within a bioenergetic stress model, where factors which heighten acute metabolic distress lead to more neuropsychobiological problems.

Aluminum in tobacco and cannabis and smoking-related disease

PURPOSE

The study aimed to confirm the very high content of aluminum in tobacco and cannabis and to provide for the first time evidence that such aluminum could be biologically available.

METHODS

Complete digestion of tobacco and cannabis was achieved using a 50:50 mixture of 14 M HNO3 and 0.1 M NaF. Total Al in digests was measured by graphite furnace atomic absorption spectrometry. A bespoke cigarette smoking apparatus was used to determine if aluminum in active or passive tobacco/cannabis smoke would be trapped by a surrogate lung fluid.

RESULTS

The aluminum content of tobacco and cannabis was confirmed to be high, as much as 0.37% and 0.4% by weight respectively. Aluminum in tobacco and cannabis smoke, whether actively (drawn) or passively inhaled, was shown to accumulate significantly in surrogate lung fluids, thus demonstrating its potential biological availability.

CONCLUSIONS

Active and passive smoking of tobacco or cannabis will increase the body burden of aluminum and thereby contribute to respiratory, neurological and other smoking-related disease.

Nicotine psychobiology: how chronic-dose prospective studies can illuminate some of the theoretical issues from acute-dose research

RATIONALE

To illustrate how prospective cigarette smoking research can illuminate some of the theoretical dilemmas about nicotine psychobiology from acute dose research.

METHODS AND RESULTS

When briefly deprived smokers are administered nicotine, they display a range of psychobiological 'gains', with improved cognitive performance, feelings of contentment, and reduced feelings of stress or depression. However, abstinence leads to decrements in all these functions. The balance between the deficits of nicotine deprivation and the gains of reinstatement has been debated for decades. Yet, it still remains controversial whether nicotine is psychobiologically beneficial, neutral or detrimental. Some illumination may be provided by prospective research. Taking up smoking during adolescence is often followed by increased feelings of stress and depression, whereas quitting is often associated with subsequent mood gains. Short-term prospective studies reveal that the essence of nicotine dependency is repetitive psychobiological vascillation. The mood gains of smoke inhalation represent the temporary reversal of abstinence effects, and the frequent experience of negative states in between cigarettes explains why smoking can increase psychobiological distress. This may also be linked with Diathesis-Stress models. If withdrawal symptoms reflect the exacerbation of natural predispositions, then 'disadvantaged' smokers will suffer the worst abstinence symptoms and develop the strongest nicotine dependency. This explanation contrasts with the self-medication model, which focuses on the immediate benefits of smoke inhalation, rather than the overall costs of nicotine use.

CONCLUSIONS

The frequent experience of negative psychological states in between cigarettes helps to explain why nicotine dependency is associated with a range of psychobiological problems.