Neuropsychological Performance in Alcohol Dependent Patients: A One-Year Longitudinal Study
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective Despite several studies that have highlighted the harmful effects of alcohol consumption on cognitive functions it remains unclear whether certain brain areas are more sensitive than others are or whether alcohol causes widespread cognitive deficit. Moreover, the role of continued abstinence has yet to be clarified regarding the quality of recovery on the different cognitive domains. The aim of this 1-year longitudinal study was to evaluate the recovery of cognitive deficits in the medium (6 months) and long term (12 months) after the interruption of drinking. Methods Forty-one alcohol-dependent patients were recruited from two outpatient treatment facilities and cognitive functions were compared on a control group of forty healthy controls. The patients were then re-assessed at 6 and 12 months. Changes in neuropsychological measures were evaluated with repeated measures analysis of variance (ANOVA). We also compared 1-year follow-up scores with control data (unpaired t tests) to identify tests on which significant differences persisted. Results Patients performed significantly worse than controls in all cognitive domains investigated and this cognitive impairment was evident in recently abstinent patients. A year of abstinence resulted in a significant improvement in all cognitive domains assessed after detoxification from alcohol. After year 1, alcoholic subjects had returned to normal levels compared to healthy controls on all domains except for general non-verbal intelligence, verbal memory and some visuospatial skills. Conclusion Our results support the hypothesis of widespread impairment resulting from alcohol consumption. The recovery of cognitive functions is not homogeneous during prolonged abstinence.
Abstract
Objective Despite several studies that have highlighted the harmful effects of alcohol consumption on cognitive functions it remains unclear whether certain brain areas are more sensitive than others are or whether alcohol causes widespread cognitive deficit. Moreover, the role of continued abstinence has yet to be clarified regarding the quality of recovery on the different cognitive domains. The aim of this 1-year longitudinal study was to evaluate the recovery of cognitive deficits in the medium (6 months) and long term (12 months) after the interruption of drinking. Methods Forty-one alcohol-dependent patients were recruited from two outpatient treatment facilities and cognitive functions were compared on a control group of forty healthy controls. The patients were then re-assessed at 6 and 12 months. Changes in neuropsychological measures were evaluated with repeated measures analysis of variance (ANOVA). We also compared 1-year follow-up scores with control data (unpaired t tests) to identify tests on which significant differences persisted. Results Patients performed significantly worse than controls in all cognitive domains investigated and this cognitive impairment was evident in recently abstinent patients. A year of abstinence resulted in a significant improvement in all cognitive domains assessed after detoxification from alcohol. After year 1, alcoholic subjects had returned to normal levels compared to healthy controls on all domains except for general non-verbal intelligence, verbal memory and some visuospatial skills. Conclusion Our results support the hypothesis of widespread impairment resulting from alcohol consumption. The recovery of cognitive functions is not homogeneous during prolonged abstinence.
참고문헌 (43)
- Fein G, "Neuroplasticity in human alcoholism: studies of extended abstinence with potential treatment implications", Alcohol Res, 37, pp.125~141 (2015)
- Ioime L, "The importance of cognitive assessment in the management of psychiatric disorders", Res Adv Psychiatry, 1, pp.44~45 (2014)
- Zaninotto L, "A meta-analysis of cognitive performance in melancholic versus non-melancholic unipolar depression", J Affect Disord, 201, pp.15~24 (2016)[DOI]
- Zaninotto L, "Cognitive markers of psychotic unipolar depression: a meta-analytic study", J Affect Disord, 174, pp.580~588 (2015)[DOI]
- Allsop S, "The process of relapse in severely dependent male problem drinkers", Addiction, 95, pp.95~106 (2000)[DOI]
- Wolwer W, "Out-patient behaviour therapy in alcoholism: impact of personality disorders and cognitive impairments", Acta Psychiatr Scand, 103, pp.30~37 (2001)[DOI]
- Camchong J, "Resting-state synchrony in long-term abstinent alcoholics", Alcohol Clin Exp Res, 37, pp.75~85 (2013)[DOI]
- Bush G, "Cognitive and emotional influences in anterior cingulate cortex", Trends Cogn Sci, 4, pp.215~222 (2000)[DOI]
- Bolla KI, "Differential effects of cocaine and cocaine alcohol on neurocognitive performance", Neurology, 54, pp.2285~2292 (2000)[DOI]
- Ratti MT, "Chronic alcoholism and the frontal lobe: which executive functions are imparied?", Acta Neurol Scand, 105, pp.276~281 (2002)
- Saraswat N, "Set-shifting and selective attentional impairment in alcoholism and its relation with drinking variables", Indian J Psychiatry, 48, pp.47~51 (2006)[DOI]
- Loeber S, "Impairment of cognitive abilities and decision making after chronic use of alcohol: the impact of multiple detoxifications", Alcohol Alcohol, 44, pp.372~381 (2009)[DOI]
- Fein G, "Cognitive impairments in abstinent alcoholics", West J Med, 152, pp.531~537 (1990)
- Lezak MD, "Neuropsychological Assessment" (1995), Oxford University Press
- Oscar-Berman M, "Asymmetries of Brain Function in Alcoholism: Relationship to Aging;Neurobehavior of Language and Cognition", pp.213~240 (2002), Springer US
- Wilson JT, "Visual event perception in alcoholics", J Clin Exp Neuropsychol, 10, pp.222~234 (1988)[DOI]
- Kopera M, "Cognitive functions in abstinent alcohol-dependent patients", Alcohol, 46, pp.665~671 (2012)[DOI]
- Glass JM, "Effects of alcoholism severity and smoking on executive neurocognitive function", Addiction, 104, pp.38~48 (2009)[DOI]
- Stavro K, "Widespread and sustained cognitive deficits in alcoholism: a meta-analysis", Addict Biol, 18, pp.203~213 (2013)[DOI]
- American Psychiatric Association. Task Force on DSM-IV. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, "American Psychiatric Association", American Psychiatric Association, ~ (2000)
- First MB, "Structured Clinical Interview for DSM-IV Axis I Disorders: SCID-I: Clinician Version: Administration Booklet" (1997), American Psychiatric Press
- Martinotti G, "Pregabalin in clinical psychiatry and addiction: pros and cons", Expert Opin Investig Drugs, 21, pp.1243~1245 (2012)[DOI]
- Guglielmo R, "Pharmacological treatments in alcohol use disorders: state of art and new perspectives", Clin Ter, 166, pp.262~270 (2015)
- Sobell L, "Alcohol Timeline Followback User's Manual" (1995), Addiction Research Foundation
- Guy W, "ECDEU Assessment Manual for Psychopharmacology" (1976), U.S. Department of Health, Education, and Welfare
- Janiri L, "The Italian version of the Obsessive-Compulsive Drinking Scale: validation, comparison with the other versions, and difference between type 1- and type 2-like alcoholics", Drug Alcohol Depend, 74, pp.187~195 (2004)[DOI]
- Hamilton M, "A rating scale for depression", J Neurol Neurosurg Psychiatry, 23, pp.56~62 (1960)[DOI]
- Caffarra P, "A normative study of a shorter version of Raven's progressive matrices 1938", Neurol Sci, 24, pp.336~339 (2003)[DOI]
- Giovagnoli AR, "Trail making test: normative values from 287 normal adult controls", Ital J Neurol Sci, 17, pp.305~309 (1996)[DOI]
- Caffarra P, "Una versione abbreviata del test di Stroop: dati normativi nella popolazione italiana", Nuova Rivista di Neurologia, 12, pp.111~115 (2002)
- Caffarra P, "Modified Card Sorting Test: normative data", J Clin Exp Neuropsychol, 26, pp.246~250 (2004)[DOI]
- Carlesimo GA, "The Mental Deterioration Battery (Part 3): standardization and diagnostic reliability in the identification of demented patients", Archivio di psicologia, neurologia e psichiatria, 56, pp.489~502 (1995)
- Caffarra P, "Rey-Osterrieth complex figure: normative values in an Italian population sample", Neurol Sci, 22, pp.443~447 (2002)[DOI]
- Carlesimo GA, "The Mental Deterioration Battery (Part 2): standardization and diagnostic reliability in the identification of demented patients", Archivio di psicologia, neurologia e psichiatria, 56, pp.471~488 (1995)
- Cohen J, "Statistical Power Analysis for the Behavioral Sciences" (1988), L. Erlbaum Associates
- Hommer D, "Evidence for a gender-related effect of alcoholism on brain volumes", Am J Psychiatry, 158, pp.198~204 (2001)[DOI]
- Leber WR, "Recovery of visual-spatial learning and memory in chronic alcoholics", J Clin Psychol, 37, pp.192~197 (1981)[DOI]
- Camchong J, "Decision making, risky behavior, and alcoholism", Handb Clin Neurol, 125, pp.227~236 (2014)
- Field M, "Acute alcohol effects on inhibitory control and implicit cognition: implications for loss of control over drinking", Alcohol Clin Exp Res, 34, pp.1346~1352 (2010)
- Moselhy HF, "Frontal lobe changes in alcoholism: a review of the literature", Alcohol Alcohol, 36, pp.357~368 (2001)[DOI]
- Houben K, "Resisting temptation: decreasing alcohol-related affect and drinking behavior by training response inhibition", Drug Alcohol Depend, 116, pp.132~136 (2011)[DOI]
- Jones A, "The effects of cue-specific inhibition training on alcohol consumption in heavy social drinkers", Exp Clin Psychopharmacol, 21, pp.8~16 (2013)[DOI]
- Wiers RW, "Should we train alcohol-dependent patients to avoid alcohol", Front Psychiatry, 4, pp.33~ (2013)