Alcohol-related Impairment Research Articles

Characterizing Midlife-Onset Alcohol Dependence: Implications for Etiology, Prevention, and Healthy Aging

We evaluated the developmental epidemiology of midlife-onset alcohol dependence (AD) in the Dunedin Study ( N = 1,037), a population-representative cohort followed across 5 decades. At ages 18, 21, 26, 32, 38, and 45, past-year AD prevalence was 11.0%, 18.4%, 13.6%, 8.1%, 9.6%, and 11.3%, respectively. As expected, relative to never-diagnosed individuals, individuals with early onset AD (first diagnosis at age 18 or age 21, prevalence = 22.9%) were distinguished by a range of early life and adult correlates. Individuals with midlife-onset AD (first diagnosis at age 38 or age 45, prevalence = 5.6%) were distinguished by fewer early life correlates, but exhibited a family history of AD and adolescent dysregulation and marijuana use. They were characterized by an array of adult correlates, including internalizing disorders, mental-health-treatment contact, criminal behavior, perceived stress, coping by drinking, lower likelihood of marriage and parenthood, and reduced preparedness for old age. They also experienced more adult alcohol-related impairment than the early onset group. Results can guide efforts to reduce midlife alcohol-related problems and support healthy aging.

Protective Effects and Mechanism of Heracleum moellendorffii Hance on Alcohol-Induced Cognitive Decline in Mice.

Chronic and continuous alcohol consumption increases the risk of cognitive decline and may lead to alcohol-related dementia. We investigated the potential of Heracleum moellendorffii Hance root extract (HME) for treating alcohol-related cognitive impairment. Behavioral tests evaluated the effects of HME on cognitive function and depression. Changes in hippocampus and liver tissues were evaluated by Western blotting and H&E staining. The group treated with HME 200 mg/kg showed a significant increase in spontaneous alternation in Y-maze and a decrease in immobility in a forced swimming test (FST) compared to the vehicle-treated group. These results suggest that HME can restore memory deficits and reverse depressive symptoms caused by chronic alcohol consumption. The HME-treated group also upregulated brain-derived neurotrophic factor (BDNF), phosphorylated extracellular signal-regulated kinase 1/2 (ERK1/2), and phosphorylated cAMP response element-binding protein (CREB) in the hippocampus. Additionally, it reduced lipid vacuolation in the liver and increased the expression of aldehyde dehydrogenase 1 (ADH1). The administration of HME improves cognitive impairment and reverses depressive symptoms due to alcohol consumption, restoring neural plasticity in the hippocampus and alcohol metabolism in the liver. These findings suggest that HME is a promising treatment for alcohol-related brain disorders. Molecular mechanisms underlying the therapeutic effects of HME and its active ingredients should be investigated further.

Memantine alleviates cognitive impairment and hippocampal morphology injury in a mouse model of chronic alcohol exposure

Alcohol-related cognitive impairment (ARCI) is highly prevalent among patients with alcohol abuse and dependence. The pathophysiology of ARCI, pivotal for refined therapeutic approaches, is not fully elucidated, posing a risk of progression to severe neurological sequelae such as Korsakoff's syndrome (KS) and Alcohol-Related Dementia (ARD). This study ventures into the underlying mechanisms of chronic alcohol-induced neurotoxicity, notably glutamate excitotoxicity and cytoskeletal disruption, and explores the therapeutic potential of Memantine, a non-competitive antagonist of the N-methyl-d-aspartate (NMDA) receptor known for its neuroprotective effect against excitotoxicity. Our investigation centers on the efficacy of Memantine in mitigating chronic alcohol-induced cognitive and hippocampal damages in vivo. Male C57BL/6J mice were subjected to 30 % (v/v, 6.0 g/kg) ethanol via intragastric administration alongside Memantine co-treatment (10 mg/kg/day, intraperitoneally) for six weeks. The assessment involved Y maze, Morris water maze, and novel object recognition tests to evaluate spatial and recognition memory deficits. Histopathological evaluations of the hippocampus were conducted to examine the extent of alcohol-induced morphological changes and the potential protective effect of Memantine. The findings reveal that Memantine significantly improves chronic alcohol-compromised cognitive functions and mitigates hippocampal pathological changes, implicating a moderating effect on the disassembly of actin cytoskeleton and microtubules in the hippocampus, induced by chronic alcohol exposure. Our results underscore Memantine's capability to attenuate chronic alcohol-induced cognitive and hippocampal morphological harm may partly through regulating cytoskeleton dynamics, offering valuable insights into innovative therapeutic strategies for ARCI.

Performance validity testing in individuals with alcohol-related cognitive impairments.

Performance validity testing in individuals with alcohol-related cognitive impairments.

Emotion differentiation and intimate partner violence: Effects of provocation and alcohol intoxication.

This study investigated the impact of relational provocation on intimate partner violence (IPV) perpetration as a function of alcohol intoxication and individuals' emotion differentiation (ED; i.e., the ability to differentiate between positive and negative emotions). We hypothesized that provocation and acute intoxication would be associated with lower ED, such that individuals would demonstrate lower ED following provocation and while intoxicated. We also hypothesized an intoxication-by-ED interaction, such that only individuals who were intoxicated and undifferentiated would perpetrate IPV. Two hundred fifty community-based adults completed an aggression paradigm ostensibly with their romantic partners where they were randomly assigned to an alcohol or no-alcohol condition. Participants' ED across positive and negative subscales was calculated at baseline (Time 1), postprovocation and intoxication (Time 2), and postbehavioral aggression (Time 3). IPV was operationalized as the strength and duration of shocks issued to their partner during the aggression paradigm. Both sober and intoxicated participants experienced lower ED following provocation, suggesting a main effect of provocation but no main effect of intoxication. There was a significant alcohol-by-ED interaction in the predicted direction. For intoxicated participants, low ED was associated with greater IPV perpetration. For sober participants, low ED was associated with less IPV perpetration. Consistent with hypotheses, low ED is associated with greater IPV perpetration among intoxicated individuals. In contrast to prior research, low ED was associated with less IPV perpetration among sober individuals. Alcohol-related cognitive impairments may increase the likelihood of IPV perpetration by disrupting the ED process that may otherwise inhibit impulsive aggression. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Alcohol-related cognitive impairments in patients with and without cirrhosis.

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-). 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. 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). 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.

Measuring episodic verbal learning ability in alcohol-related cognitive disorders in relation to everyday functioning

Adequate and timely assessment of learning abilities in individuals with alcohol-related cognitive disorders is highly relevant to optimize addiction care. Learning curves of episodic verbal memory tests have been used to assess learning ability in various neurocognitive disorders, but studies in alcohol-related cognitive disorders are lacking. Therefore, this study investigated California Verbal Learning Test (CVLT) learning curves in individuals with alcohol-use disorder (AUD) with and without cognitive impairments and examined associations between learning curves and changes in everyday functioning following a multicomponent care program. We fitted learning curves over the five immediate recall trials of the Dutch version of the CVLT of patients with Korsakoff's syndrome (KS; N = 117), alcohol-related cognitive impairment no KS (ARCI; N = 147), and uncomplicated AUD (N = 43) using a generalized non-linear mixed regression. This model was based on three different parameters: initial memory performance (attention), maximum number of correctly recalled words (maximum learning), and the increase of correctly recalled words over the trials (learning rate). Next, we related these learning curves with ratings of everyday activities using the Patient Competency Rating Scale (PCRS) before and after a care program following admission. Modelled learning curves differed across groups, with significant differences in Attention (KS<ARCI<AUD, p < 0.001), Maximum Learning (KS<ARCI<AUD, p<0.001), and Learning Rate (KS<ARCI=AUD, p < 0.001). However, modelled learning curves were not related to reliable improvement in PCRS scores (p>0.05). Although modelled learning curves may be used to differentiate diagnostic groups in alcohol-related cognitive disorders, future studies are needed to establish the criterion validity of learning curves in this population.

Secondary physical features in children with FASD

ObjectiveThe diagnoses included within the umbrella term fetal alcohol spectrum disorders (FASD), are based on the documentation of prenatal alcohol exposure (PAE), growth deficits and a pattern of dysmorphic physical features and neurobehavioral impairments. Although 3 key facial features (short palpebral fissures, a smooth philtrum and a thin vermilion of the upper lip) are the only dysmorphic features taken into account for the diagnosis of Fetal Alcohol Syndrome (FAS) or partial FAS (pFAS), several other features are commonly seen in individuals with these diagnoses. The goals of our study were to determine if some of these secondary physical features also occur more frequently in children with alcohol-related neurodevelopmental disorder (ARND) relative to controls, and if a cluster of these features combined in a dysmorphology score could be used to identify those negatively impacted by PAE but who do not have the cardinal physical features that led to a diagnosis of FAS or pFAS. MethodsAmong 2681 children recruited for the Collaboration on Fetal Alcohol Spectrum Disorders Prevalence (CoFASP) study, 1726 had an FASD or sufficient evidence of PAE having occurred or not in their pregnancy. Children were then categorized into groups using the modified Hoyme diagnostic criteria (FAS (n = 24), pFAS (n = 99) and ARND (n = 87), and No FASD (n = 1516), including those with No FASD and a history of PAE (No FASD/PAE, n = 498) and those with No FASD and no history of PAE (No FASD/No PAE, n = 1018). The frequencies of 26 secondary dysmorphic features were compared among these groups, both individually and combined in non-weighted and weighted dysmorphic scores. Correlations of the total dysmorphic scores with an index of overall cognitive ability were also compared by group status. ResultsSeveral of these features were significantly more frequent in children with FAS than in those with No FASD diagnosis with or without PAE but not in comparison to those with ARND. The number of features was also significantly higher in the FAS group as compared to all other groups for both weighted and unweighted dysmorphology scores but were not higher in the group with ARND when compared to the groups with No FASD either in the presence or absence of PAE. Although not diagnostic, higher total dysmorphology scores were predictive of lower general cognitive abilities in the group with ARND, suggesting severity of alcohol-related dysmorphology is predictive of severity of alcohol-related neurobehavioral impairment. ConclusionSecondary physical features were not more frequent in children with ARND compared to children without an FASD diagnosis but were a marker for lower cognitive function. The use of secondary physical features to support a diagnosis of ARND was not supported in this sample.

65 Learning Ability in Relation to Everyday Activities in Patients with Korsakoff’s Syndrome, Other Alcohol-Related Cognitive Impairments, or Uncomplicated Alcohol Use Disorder

Objective:Assessment of learning potential in patients with cognitive disorders in individuals with alcohol-related cognitive disorders (including Korsakoff’s syndrome; KS) is highly relevant, as this may help to tailor interventions, guide treatment planning and help to optimize care. However, studies on assessing learning potential or learning ability using neuropsychological assessment in relation to changes in everyday activities during the course of treatment are scarce. In this study we examined whether verbal and visuospatial learning curves could be used as an index of learning ability in relation to everyday activities before and after a treatment program.Participants and Methods:We examined the episodic learning ability of patients with KS (N=137), other alcohol-related cognitive impairments (ARCI; N=164), and uncomplicated alcohol use disorder (AUD; N=49). For this, we calculated the learning curves for the California Verbal Learning Test (CVLT) and the Location Learning Test - Revised (LLT-R) and examined their association with ratings of everyday activities by the patient and his/her professional caregiver using the Patient Competency Rating Scale (PCRS) before and after a 10-12 week treatment program following admission to the Korsakoff Centre.Results:For both verbal and visuospatial memory, the AUD group had a steeper learning curve than the ARCI patients, who in turn had a steeper learning curve than the KS group (p&lt;.01). While the VLGT total score was related to the PCRS in all patient groups (Pearson r&gt;.38, p&lt;.01), this was only the case for the KS group for the LLT-R total score (r&gt;-.29, p&lt;.01). However, the learning curve estimates of both tests were neither related to the PCRS absolute scores (for patients and caregivers, before and after treatment) nor to the APCRS scores during the course of the treatment program.Conclusions:Episodic learning ability, as measured with the learning curves of the CVLT and LLT-R, were unrelated to the patients everyday activity level as measures by the patients themselves or their professional caregiver. The results will be discussed in relation to other tools for assessing the learning potential of cognitively impaired patients, such as dynamic testing.

Impaired Executive Functioning Associated with Alcohol-Related Neurocognitive Disorder including Korsakoff's Syndrome.

(1) Background: chronic alcohol use is consistently associated with impaired executive functioning, but its profile across the spectrum from mild to major alcohol-related cognitive impairment is, to date, unclear. This study aims to compare executive performances of patients with alcohol-induced neurocognitive disorder, including Korsakoff's syndrome (KS), by using a computerized assessment battery allowing a fine-grained and precise neuropsychological assessment; (2) Methods: performances of 22 patients with alcohol-related cognitive impairment (ARCI) and 20 patients with KS were compared to those of 22 matched non-alcoholic controls. All participants were diagnosed in accordance with DSM-5-TR criteria and were at least six weeks abstinent from alcohol prior to assessment. Executive function was evaluated using four subtests of Cambridge Neuropsychological Test Automated Battery (CANTAB®); (3) Results: significant differences between groups were found on spatial working memory (updating), sustained attention and inhibitory control, set shifting, and planning. Healthy controls performed significantly better than both patient groups (Games-Howell post hoc; p < 0.05), but no differences in performance were found between the ARCI and KS group; (4) Conclusions: ARCI and KS patients showed significant executive impairments, most prominent in updating, set-shifting and general planning abilities. Findings suggest equivalent levels of executive function in ARCI and KS patients. Our results highlight executive function as a significant hallmark of alcohol-induced neurocognitive disorder and stipulate the importance of early assessment and evaluation of skills to guide treatment.

Who affiliates with SMART recovery? A comparison of individuals attending SMART recovery, alcoholics anonymous, both, or neither.

Mutual-help organizations (MHOs) play a crucial role for many individuals with alcohol use disorder (AUD) or other substance use disorders in achieving stable remission. While there is now substantial research characterizing who uses 12-step MHOs, very little is known about who becomes affiliated with newer and rapidly growing MHOs, such as Self-Management and Recovery Training ("SMART" Recovery). More research could inform knowledge regarding who may be best engaged by these differing pathways. We conducted a cross-sectional analysis of participants (N = 361) with AUD recruited mostly from the community who were starting a new recovery attempt and self-selected into one of four different recovery paths: (1) SMART Recovery ("SMART-only"; n = 75); (2) Alcoholics Anonymous ("AA-only"; n = 73); (3) Both SMART and AA ("Both"; n = 53); and (4) Neither SMART nor AA ("Neither"; n = 160). We compared the groups on demographics, clinical history, treatment and recovery support service use, and indices of functioning and well-being. We computed descriptives and conducted inferential analyses according to the data structure. Compared to study participants choosing AA-only or Both, SMART-only participants were more likely to be White, married, have higher income and more education, be full-time employed, and evince a pattern of lower clinical severity characterized by less lifetime and recent treatment and recovery support services usage, lower alcohol use intensity and fewer consequences, and less legal involvement. AUD symptom levels, lifetime psychiatric diagnoses, psychiatric distress, and functioning were similar across MHO-engaged groups. SMART Recovery appears to attract individuals with greater psychosocial stability and economic advantage and less severe histories of alcohol-related impairment and legal involvement. Findings suggest that certain aspects specific to the SMART Recovery group approach, format, and/or contents may appeal to individuals exhibiting this type of profile. As such, SMART appears to provide an additional resource that expands the repertoire of options for individuals with AUD who seek recovery.

Significance of Selected Environmental and Biological Factors on the Risk of FASD in Women Who Drink Alcohol during Pregnancy.

Prenatal alcohol exposure (PAE), which refers to alcohol consumption by pregnant women, is associated with the risk of numerous severe complications during fetal development. The State Agency for Alcohol Problem Solving reports that the incidence of fetal alcohol spectrum disorder (FASD) in Poland's general population is over 1.7%, and the incidence of fetal alcohol syndrome (FAS) is estimated at more than 0.5%. This study aimed to evaluate the significance of alcohol exposure and focused on the pattern of alcohol intoxication exhibited by the mother during pregnancy and other environmental factors of the maternal environment contributing to the development of FASD. The study covered 554 subjects, including 251 mothers and 303 children (213 girls and 90 boys). The mother's drinking problem was determined based on the information obtained from the case history. All children qualified for the study fulfilled the h-PAE (high alcohol exposure) criteria during their fetal life. The clinical diagnosis of FAS and pFAS (occurrence of morphological symptoms of fetal alcohol syndrome) was made using a four-digit diagnostic questionnaire validated in the Polish version of the Washington Questionnaire for the assessment of the spectrum of alcohol-related neurodevelopmental disorders or alcohol-related cognitive impairment (ARND/C). Statistical analysis of the obtained research results was developed using statistical software-STATISTICA PL, version 13.1 (StatSoft, Inc., Szczecin, Poland 2016, STATISTICA-data analysis software system, version 13.1). The most destructive drinking behaviors are compulsive intoxication (BD, binge drinking) during the first 6 weeks of pregnancy and chronic addiction throughout its duration (CHD, chronic drinking). Chronic alcohol intoxication (CHD) leads to a poorer nutritional status in mothers, which is reflected in a lower body mass index (BMI) (<18 kg/m2).

Substance use disparities by age, race, sex, and sexual orientation among persons living with HIV in the Southern U.S.

Alcohol and drug use is overrepresented among individuals living with Human Immunodeficiency Virus (HIV) and is associated with poor health outcomes. Determining the extent to which substance use differs between demographic profiles of people living with HIV (PLWH) would determine at-risk groups that would benefit from intervention. Cross-sectional screening data (N = 1307, Mage = 42.7years, 66% male, 86% African American, 39% sexual minority) was examined from an HIV clinic in the southern U.S. largely treating underserved and low-income patients. Age, gender, race/ethnicity, sexual orientation, and their interactions were entered as predictors of substance use and related impairment in a series of zero-inflated negative binomial regressions. African Americans reported more drug use (p = 0.004) and drug-related negative consequences (p = 0.003). Notably, alcohol-related negative consequences of African American heterosexuals were much higher at younger ages, compared to sexual minorities (regardless of race) and White heterosexuals of all age groups (p = 0.04). Among PLWH in the U.S. South, African Americans may be uniquely at-risk with for problems related to drug-related functional impairment. Specifically, young heterosexual African Americans are at high risk for alcohol-related impairment. Implications are discussed.

Alcohol related cognitive impairments in schizophrenia patients : A case-control study

IntroductionCognitive impairment is a well-recognized key feature of schizophrenia. However, these cognitive impairments may be worsened by alcohol consumption. Up to 80% of patients with alcohol use disorders (AUD) display cognitive impairments. Screening for those impairments with a full neuropsychological assessment may be difficult. The Brief Evaluation Alcohol-Related Neuropsychological Impairments (BEARNI) is a specific tool for screening those impairments easy to implement in in clinical practice (Ritz et al. Alcoholism: Clinical and Experimental Research 2015; 39, 2249-60). To our knowledge, no previous studies have assessed the alcohol-related cognitive impairments using the BEARNI test in schizophrenia patients.ObjectivesThe objective of the study was to compare BEARNI mean scores between a group of schizophrenia patients with alcohol use disorders and a group of schizophrenia patients without alcohol use disorder.Methods39 patients with schizophrenia and AUD (SCZ/AUD +) (82% males, mean age 44.9 ± 11.0 years-old) and 49 patients with schizophrenia without AUD (SCZ/AUD-) (65% males, mean age 42.6 ± 11.4 years-old) consecutively included in the study, were assessed using the BEARNI test. All patients met DSM-5 criteria for schizophrenia and AUD. Demographic and clinical variables were also collected, using the Alcohol Use Disorders Identification Test (AUDIT) and the Positive and Negative Syndrome Scale (PANSS). The primary endpoint of the study was the difference in BEARNI cognitive mean scores between the SCZ/AUD+ and SCZ/AUD- groups.ResultsThere was no difference between the two groups regarding demographic variables or PANSS mean scores (59.1 ± 12.8 vs 58.1 ± 14.0; t=-0.3; p=0.7). The AUDIT mean score was higher in the group of patients SCZ/AUD+ (20.6 ± 7.8 vs 1.6 ± 1.5; t=-14.7; p&lt;0.0001). Total BEARNI and cognitive BEARNI mean scores were significantly lower in the group of patients SCZ/AUD+ compared to the group of patients SCZ/AUD- (10.6 ± 4.8 vs 12.6 ± 5.2; t=1.8, p=0.03 and 8.1 ± 3.9 vs 9.8 ± 3.6 t=2.0, p=0.04, respectively). The mean subscores of delayed verbal memory, alphabetical ordination, and alternating verbal fluency subtests were also significantly lower in the group of patients SCZ/+ group (respectively 1,0 ± 0.9 vs 1.6 ± 1.2, t= 2.5, p=0.01; 2,1 ± 1.2 vs 2.5 ± 1.1, t= 1.6, p=0.04; 3.3 ±1.5 vs 3.8 ± 1.5, t= 1.8, p=0.03).ConclusionsThe present study found cognitive impairments using BEARNI test in schizophrenia patients with AUD compared to their counterparts without AUD. Screening alcohol related cognitive impairments using BEARNI could be easier in patients in schizophrenia patients with AUD than usual neurocognitive assessmentsDisclosure of InterestNone Declared

대학생의 음주 후 블랙아웃 경험과 음주관련요인 분석 : 일개 대학의 건강조사결과를 중심으로

Background & Objectives: University students' binge drinking behavior can lead to blackouts, and frequent blackout experiences can lead to long-term brain damage and alcoholic dementia. This study aims to analyze the drinking characteristics related to the experience of blackout due to heavy drinking among university students. Methods: This study conducted an in-depth analysis of the health survey results on 2,677 students entering a dormitory at a university in April 2017. Based on this information, we performed multivariate logistic regression analysis to find the difference in drinking-related factors related to blackout experiences after drinking by gender and grade. Results: The drinking-related factors associated with university students' blackout experience after drinking were grade, monthly binge drinking, regular walking, regular aerobic exercise, the experience of alcohol-related impairment or injury in the past year, academic difficulties due to drinking in the past year and experience of being advised not to drink from others in the past year. Alcohol-induced blackout by gender and grade showed statistically significant differences by drinking-related factors(p<0.05, p<0.01, p<0.001). Conclusion: The results of this study showed that college students' blackout experiences after drinking had unique characteristics. In the future, it needs to introduce a college health survey that can systematically collect drinking-related factors of university students and perform continuous monitoring.

“Cinderella was attacked by the big bad wolf, but the police saved her”: intrusions and confabulations on story recall in Korsakoff’s syndrome and alcohol-related cognitive impairments

ABSTRACT Background The relation between confabulations and intrusions in patients with Korsakoff’s syndrome (KS) and patients with alcohol-related cognitive impairments (ARCI) remains under debate. This study examines (1) differences in the production of confabulations and intrusions between patients with KS and ARCI, (2) whether an altered fairy tale induces more intrusions, and (3) whether different types of intrusions were significantly related to confabulations. Methods Twenty-three patients with KS and twenty-two patients with ARCI recalled three different types of stories: a novel story, a fairy tale, and a modified fairy tale. Different types of intrusions were correlated with confabulation measures. Results Patients with KS produced more intrusions in the modified fairy tale condition than patients with ARCI, but these were unrelated to confabulations. Only unrelated intrusions were related to provoked confabulations. Conclusions The results of this study indicate that researchers and clinicians must be aware that in general, intrusions on memory tests should not be interpreted as confabulations. Especially spontaneous confabulations appear to be something completely different from intrusions on any type of story recall. When measuring confabulations it is crucial to use validated instruments.

Alcohol Withdrawal Is an Oxidative Stress Challenge for the Brain: Does It Pave the Way toward Severe Alcohol-Related Cognitive Impairment?

Alcohol use is a leading cause of mortality, brain morbidity, neurological complications and minor to major neurocognitive disorders. Alcohol-related neurocognitive disorders are consecutive to the direct effect of chronic and excessive alcohol use, but not only. Indeed, patients with severe alcohol use disorders (AUD) associated with pharmacological dependence suffer from repetitive events of alcohol withdrawal (AW). If those AW are not managed by adequate medical and pharmacological treatment, they may evolve into severe AW, or be complicated by epileptic seizure or delirium tremens (DT). In addition, we suggest that AW favors the occurrence of Wernicke’s encephalopathy (WE) in patients with known or unknown thiamine depletion. We reviewed the literature on oxidative stress as a core mechanism in brain suffering linked with those conditions: AW, epileptic seizure, DT and WE. Thus, we propose perspectives to further develop research projects aiming at better identifying oxidative stress brain damage related to AW, assessing the effect of repetitive episodes of AW, and their long-term cognitive consequences. This research field should develop neuroprotective strategies during AW itself or during the periwithdrawal period. This could contribute to the prevention of severe alcohol-related brain damage and cognitive impairments.

Early Improvement of Neuropsychological Impairments During Detoxification in Patients with Alcohol Use Disorder.

To assess recovery of alcohol-related neuropsychological deficits in a group of patients with pure severe alcohol use disorder (AUD) during a detoxification program using the Brief Evaluation of Alcohol-Related Neuropsychological Impairment (BEARNI) test. Thirty-two patients with severe AUD using DSM-IV criteria (24 men, mean age = 45.5 ± 6.8years old) were assessed using the BEARNI 8 ± 2days after alcohol cessation (T1) and then were reassessed within 18 ± 2days after alcohol cessation (T2). The primary study endpoint was the number of patients initially impaired at T1 who recovered cognitive functions at T2 assessment. At T1, 59% (n = 19) patients with pure severe AUD had at least one impaired cognitive function assessed by the BEARNI. At T2, 63% of the patients with AUD with deficits at T1 had normal BEARNI cognitive scores (χ2 = 7.7, P = 0.005); specifically, the percentages of participants with normal subtest scores were 63% on memory (χ2 = 12.4, P = 0.0004), 100% on verbal fluency (χ2 = 16; P = <0.0001), 60% on alphabetical span (χ2 = 12.8; P = 0.0003) and 67% on visuospatial (χ2 = 15, P = 0.0001). The cognitive impairments of two-thirds of patients with pure AUD included in the present study recovered within 18days of abstinence, earlier than reported in previous studies.

Do Overweight, Arterial Hypertension and Type 2 Diabetes Worsen Cognitive Impairment in Patients with Alcohol Use Disorders?

Objective: Overweight, Arterial Hypertension (AH) and diabetes are frequently associated with alcohol use disorders. As each of these co-morbidities is independently associated with cognitive impairment, we studied whetherthey could worsen alcohol-related cognitive impairment. Methods: A retrospective analysis of a clinical database of patients with an alcohol use disorder admitted to an addiction treatment unit of a teaching hospital. Patient weight was classified using WHO recommendations; arterial hypertension and Type 2 diabetes were diagnosed according to the most recent guidelines. Cognitive status was assessed using the MoCA administered on admission and at discharge by trained staff members. Results: Among the 387 patients included (69.3% male, mean age 50.4), 6.4% suffered from Type II diabetes, AH was present in 22.4% of the sample, and 20.6% were obese (BMI&gt;=30). MoCA scores at admission did not differ as a function of BMI, or AH or Type II diabetes status. At discharge, MoCA scoreshad improved in all subgroups; however, a multivariate analysis showed that they had improved significantly less in the AH group compared to the non-AH group. Conclusions: Our results confirm the impact of hypertension on cognitive dysfunction, including in patients with severe alcohol use disorders. Monitoring of blood pressure levels is, therefore, an important preventive measure for cognitive dysfunction in these patients.

Cyclic Nucleotide Phosphodiesterases in Alcohol Use Disorders: Involving Gut Microbiota.

Alcohol abuse is 1 of the most significant public health problems in the world. Chronic, excessive alcohol consumption not only causes alcohol use disorder (AUD) but also changes the gut and lung microbiota, including bacterial and nonbacterial types. Both types of microbiota can release toxins, further damaging the gastrointestinal and respiratory tracts; causing inflammation; and impairing the functions of the liver, lung, and brain, which in turn deteriorate AUD. Phosphodiesterases (PDEs) are critical in the control of intracellular cyclic nucleotides, including cyclic adenosine monophosphate and cyclic guanosine monophosphate. Inhibition of certain host PDEs reduces alcohol consumption and attenuates alcohol-related impairment. These PDEs are also expressed in the microbiota and may play a role in controlling microbiota-associated inflammation. Here, we summarize the influences of alcohol on gut/lung bacterial and nonbacterial microbiota as well as on the gut-liver/brain/lung axis. We then discuss the relationship between gut and lung microbiota-mediated PDE signaling and AUD consequences in addition to highlighting PDEs as potential targets for treatment of AUD.