Alcoholic Research Articles

Renaissance of Ketamine

The history of ketamine began in the 1960s. Ketamine is a specific anesthetic drug that exhibits analgesia, has a stabilizing impact on the cardiovascular system and does not significantly depress the respiratory system. It is responsible for causing the so-called dissociative effect. The effects of ketamine depend on the dose. Its mechanism of action is based primarily on the blockade of N-methyl D-aspartic acid receptors (NMDA) in the central nervous system. Due to its favorable action profile and small number of contraindications, ketamine is becoming an increasingly popular drug. In medicine, it is commonly used as an analgesic and an anesthetic. Studies conducted over recent years have noted that it can be effective in conditions such as: status epilepticus, status asthmaticus, agitation, alcohol dependence and alcohol withdrawal syndrome, depression, and suicidal thoughts. This paper reviews current reports on the uses of ketamine, beneficial especially to physicians with the Specialty in emergency medicine.

Is self-compassion a protective factor for addictions? Exploring its effects on alcohol and gambling-related problems using a self-compensation model framework among a Chinese adult sample in Hong Kong, China

Is self-compassion a protective factor for addictions? Exploring its effects on alcohol and gambling-related problems using a self-compensation model framework among a Chinese adult sample in Hong Kong, China

Sexual Dysfunction, Marital Adjustment, and Quality of Life Among Male Persons with Alcohol Dependence Syndrome Attending Tertiary Healthcare Institution in Northeast India: A Cross-Sectional Study

Background: Sexual dysfunction is one of the major problems associated with the chronic use of alcohol. Sexual dysfunction is also significantly associated with marital adjustment and quality of life. Aim and objectives: To determine the prevalence of sexual dysfunction and its association with marital adjustment and quality of life among persons with alcohol dependence syndrome (ADS) and to compare with the healthy control group. Materials and methods: The present study used a cross-sectional, comparative, and descriptive research design. A purposive sampling technique was used to select the sample of 128 (64 patients with ADS and 64 healthy control persons) between the ages of 21 and 50, from the Department of Addiction Medicine, LGB Regional Institute of Mental Health (LGBRIMH), Tezpur, Assam. Sociodemographic and clinical data sheet, the Arizona Sexual Experience Scale (ASEX), the Severity of Alcohol Dependence Questionnaire (SDAQ), the Alcohol Use Disorders Identification Test (AUDIT), the International Index of Erectile Dysfunction (IIED), and The Drug Abuse Screening Test scales (DAST) were used. Results: The study revealed a higher prevalence of sexual dysfunction in the ADS group (64%) compared to the healthy control group (35.9%) (Chi-square = 46.916; p < .001). Marital satisfaction was significantly lower in the ADS group than in the healthy control group (Fisher’s exact test = 76.932; p < .001). Quality of life was also diminished in the ADS group, particularly in the physical ( t = −5.310; p <.001), social ( t = −4.481; p < .001), and environmental domains ( t = −4.250; p < .001). Furthermore, sexual dysfunction exhibited a significant negative correlation with marital adjustment ( r = −0.676; p < .01) and all domains of quality of life [physical domain ( r = −0.235; p < .001), social domain ( r = −0.383; p < .001), and environmental domain ( r = −0.383; p < .001)]. Conclusion: The prevalence of sexual dysfunction and erectile dysfunction was high in persons with alcohol dependence syndrome as compared to the healthy control group and it has a relationship with marital adjustment and quality of life. The findings highlight the importance of screening and evaluating sexual dysfunction in individuals with alcohol dependence. Comprehensive pharmacological and nonpharmacological services are warranted to address the unique needs of this population, promoting both recovery from alcohol dependence and improvement in overall quality of life.

Factors influencing hospital readmission rates in alcohol use disorder

According to data from the Federal Statistical Office, the diagnosis of alcohol use disorder (AUD) (F10) is the second most common main diagnosis for hospital treatment. Those affected by this disorder are often repeatedly hospitalized at short intervals due to relapses; however, little is known about the factors that influence readmission rates after initial treatment. The aim of this retrospective analysis is to analyze the effects of treatment type (qualified withdrawal treatment(QE) versus physical detoxification) and discharge mode on the probability of readmission in alcohol-dependent patients after inpatient treatment. Data from 981 male and female alcohol-dependent patients who completed either qualified withdrawal treatment (QE) (68% men; mean age47.6 years) or inpatient detoxification (74% men; mean age48.0 years) were analyzed. Predictors of regular discharge were determined separately for both types of treatment using stepwise logistic regression. Patients who had completed aqualified withdrawal treatment were significantly more likely to be regularly discharged. Regular completion of the qualified withdrawal treatment (QE) led to arelative reduction in the readmission rate of 25.64% within 1 year compared to aphysical detoxification. In order to prevent readmission and chronic courses of alcohol use disorder (AUD), qualified withdrawal treatment should always be recommended to affected patients instead of physical detoxification. Aktuelle Daten des Statistischen Bundesamtes für das Jahr 2022 zeigen, dass die Diagnose "Psychische und Verhaltensstörungen durch Alkohol (F10.X)" die zweithäufigste Hauptdiagnose bei Krankenhausbehandlungen darstellt [13]. Im Gesundheitssystem entstehen durch dieses Erkrankungsbild und seine somatischen und psychischen Folgeerkrankungen jährlich ca.10 Mrd. € direkte Kosten [13]. Dieser Sachverhalt wird dadurch kontrastiert, dass die Krankenkassen die qualifizierte Entzugsbehandlung (QE) als leitliniengerechte Goldstandardtherapie [4] wiederholt infrage stellen [10].

PET imaging in rat brain shows opposite effects of acute and chronic alcohol exposure on phosphodiesterase-4B, an indirect biomarker of cAMP activity.

The cyclic adenosine monophosphate (cAMP) cascade is thought to play an important role in regulating alcohol-dependent behaviors, with potentially opposite effects following acute versus chronic administration. Phosphodiesterase 4 (PDE4) is the primary brain enzyme that metabolizes cAMP, thereby terminating its signal. Radioligand binding to PDE4 serves as an indirect biomarker of cAMP activity, as cAMP-protein kinase A (PKA)-mediated phosphorylation of PDE4 increases its affinity for radioligand binding ~10-fold. Of the four PDE4 subtypes, PDE4B polymorphisms are known to be strongly associated with alcohol and substance use disorders. This study imaged rats with the PDE4B-preferring positron emission tomography (PET) radioligand [18F]PF-06445974 following acute and chronic ethanol administration, aiming to explore the potential of PDE4B PET imaging for future human studies. Compared to the control group treated with saline, acute alcohol administration (i.p. ethanol 0.5 g/kg) significantly increased whole brain uptake of [18F]PF-06445974 as early as 30 minutes post-exposure. This effect persisted at 2 hours, peaked at 4 hours, and diminished at 6 hours and 24 hours post-exposure. In contrast, in a rat model of alcohol dependence, [18F]PF-06445974 brain uptake was significantly reduced at 5 hours post-exposure and was normalized by 3 days. This reduction may reflect long-term adaptation to repeated alcohol-induced activation of cAMP signaling with chronic exposure. Taken together, the results suggest that PET imaging of PDE4B in individuals with alcohol use disorder (AUD) should be considered in conjunction with ongoing trials of PDE4 inhibitors to treat alcohol withdrawal and reduce alcohol consumption.

Trends in the Co-occurrence and Association Between Heavy Episodic Drinking and Generalized Anxiety Among Adolescents Between 2013 and 2023 in Finland

AbstractThe diverging trends of decreasing alcohol use and increasing anxiety symptoms among adolescents raise a question, has the strength of the well-known association between these issues also changed. This study examined changes in the co-occurrence and associations between heavy episodic drinking (HED) and generalized anxiety (GA) among Finnish adolescents between 2013 and 2023. From the repeated cross-sectional Finnish School Health Promotion Study (N = 874 110, age 13–20 years) we estimated self-reported GA symptoms and HED. The proportion of those with both HED and moderate to severe GA increased from 2.9% in 2013 to 3.6% in 2023, indicating a 21.5% relative difference. The association between GA symptoms and HED was stable during the study period (ORs 1.06–1.07). Although the association has been stable, there has been a rise in the proportion of adolescents experiencing both conditions concurrently over the past decade. This calls for strengthening the integration of mental health and substance use prevention and services.

It's Not Just What Parents Say, It's Why They Say It: Students' Perceptions of Parents' Motives for Alcohol Communication.

Previous work has investigated parents' reports of motives for communicating with their young adults about alcohol. While parents' self-reported motives may predict intentions to communicate, young adults' perceptions of their parents' motives may be important for understanding young adults' responses to parent alcohol communication. The present study was conducted to explore college students' perceptions of their parents' motives for alcohol communication and to investigate whether perceptions of these motives predict changes in alcohol consumption and related consequences during the transition to college. First-year college students (N = 306) participated in a longitudinal survey study. Baseline measures at pre-matriculation (T1) included assessments of student perceptions of their parents' motives for alcohol communication and covariates (e.g., perceived peer descriptive drinking norms, parental modeling and alcohol communication, and drinking and consequences). At a 1-month follow-up (T2), students reported on their alcohol use and consequences. Controlling for other predictors of college student drinking, results indicate that for each one-unit increase in perceived parental reactive communication motives, the incidence rate of typical weekly drinking increased by 9%, and heavy episodic drinking (HED) increased by 21%. Conversely, the incidence rate of HED decreased by 27% for each one-unit increase in perceived maternal family history communication motives. These findings suggest that college students' perceptions of their parents' motives for alcohol communication can significantly influence their drinking behavior during the transition to college.

Sex workers' professional agency, quality of life, and problematic substance use in Finland.

Sex workers suffer considerable marginalization that limits their choices and exposes them to various types of harm. Hence, it is important to examine sex workers' professional agency and its association with quality of life. In the current study, we investigated professional agency, quality of life, and problematic substance use among sex workers in Finland. Using an online survey, we collected data from 136 sex workers contacted through Finnish sex work organizations and social media platforms. We conducted correlational analyses between the study variables and linear regression analyses with professional agency as the independent variable and quality of life and problematic alcohol and drug use as dependent variables. As expected, in the regression analyses, professional agency was strongly positively associated with quality of life (β = 0.86, p < 0.001) and negatively associated with problematic alcohol (β = -0.38, p = 0.002) and drug (β = -0.69, p < 0.001) use. Professional agency explained as much as 73% of the variance in quality of life. Most sex workers rated their quality of life as either good or very good. Our results underscore the importance of professional agency to sex workers' well-being, explaining a substantial proportion of the variance in quality of life. Promoting agency should therefore be at the heart of sex work policymaking. However, as most of the respondents were Finnish-born cis women, our results might not generalize to foreign-born, male, and gender diverse sex workers. Future studies should prioritize reaching these populations to ensure broader representativeness.

Associations of head and neck cancers with herpes zoster in the preceding five years

This population-based study investigated the risk of having had prior herpes zoster within five years preceding a diagnosis of head and neck cancer. We conducted a case-control study that included 9,191 patients with a diagnosis of head and neck cancer in Taiwan’s Longitudinal Health Insurance Database 2010 and 36,764 matched controls. We assessed the odds of patients with head and neck cancer having had a diagnosis of herpes zoster during the five years preceding head and neck cancer using multiple logistic regression analysis. The prevalence of prior herpes zoster among the total sample was 4.6%, 7.9% and 3.8% among patients with and without head and neck cancer, respectively (p < 0.001). The odds ratio of herpes zoster among the head and neck cancer- versus control group was 2.198 (95% CI = 2.001 ~ 2.415) after adjusting for sociodemographic characteristics and hypertension, diabetes, hyperlipidemia, tobacco use disorder, HPV infection, and alcohol dependence syndrome. Statistically significant excess odds were observed for all specific subtypes of head and neck cancer except for sinonasal cancer. Herpes zoster infection within the 5 years preceding a diagnosis of head and neck cancer may be a harbinger of developing head and neck cancer.

A randomized trial testing digital medicine support models for mild-to-moderate alcohol use disorder

This paper reports the results of a hybrid effectiveness-implementation randomized trial that systematically varied levels of human oversight required to support the implementation of a digital medicine intervention for persons with mild-to-moderate alcohol use disorder (AUD). Participants were randomly assigned to three groups representing possible digital health support models within a health system: self-monitored use (SM; n = 185), peer-supported use (PS; n = 186), or a clinically integrated model CI; (n = 187). Across all three groups, the percentage of self-reported heavy drinking days dropped from 38.4% at baseline (95% CI [35.8%, 41%]) to 22.5% (19.5%, 25.5%) at 12 months. The clinically integrated group showed significant improvements in mental health and quality of life compared to the self-monitoring group (p = 0.011). However, higher attrition rates in the clinically integrated group warrant consideration in interpreting this result. Results suggest that making a self-guided digital intervention available to patients may be a viable option for health systems looking to promote alcohol risk reduction. This study was prospectively registered at clinicaltrials.gov on 7/03/2019 (NCT04011644).

Operant alcohol self-administration targets GluA2-containing AMPAR expression and synaptic activity in the nucleus accumbens in a manner that drives the reinforcing properties of the drug.

The positive reinforcing effects of alcohol (ethanol) drive its repetitive use and contribute to alcohol use disorder (AUD). Ethanol alters the expression of glutamate AMPA receptor (AMPAR) subunits in reward-related brain regions, but the extent to which this molecular effect regulates ethanol's reinforcing properties is unclear. This study investigates whether ethanol self-administration changes AMPAR subunit expression and synaptic activity in the nucleus accumbens core (AcbC) to regulate ethanol's reinforcing effects in male C57BL/6J mice. Sucrose-sweetened ethanol self-administration (0.81±0.11 g/kg/day) increased AMPAR GluA2 protein expression in the AcbC, without effect on GluA1, compared to sucrose-only controls. Infusion of myristoylated Pep2m in the AcbC, which blocks GluA2 binding to N-ethylmaleimide-sensitive fusion protein (NSF) and reduces GluA2-containing AMPAR activity, reduced ethanol-reinforced responding without affecting sucrose-only self-administration or motor activity. Antagonizing GluA2-lacking AMPARs, through AcbC infusion of NASPM, had no effect on ethanol self-administration. AcbC neurons receiving projections from the basolateral amygdala (BLA) showed increased sEPSC frequency and GluA2-like decay kinetics in ethanol self-administering mice as compared to sucrose. Optogenetic activation of these neurons revealed an ethanol-enhanced AMPA/NMDA ratio and reduced paired-pulse ratio, indicating elevated AMPAR activity and glutamate release specifically at AcbC terminals of BLA projecting neurons. Ethanol use upregulates GluA2 protein expression in the AcbC and AMPAR synaptic activity in AcbC neurons receiving BLA projections. GluA2-containing AMPAR activity in the AcbC regulates the positive reinforcing effects of ethanol through an NSF-dependent mechanism. This highlights a potential target for therapeutic interventions in AUD.

Widely used screen for cognition gets poor score in AUD cases

Accurately measuring cognitive impairment in patients with alcohol use disorder (AUD) can make a huge difference for treatment, both in identifying patients at high risk for dropout and tailoring interventions to individuals' abilities. Newly published research suggests, however, that a popular screening tool designed to bypass the need for a comprehensive neuropsychological assessment falls short in detecting cognitive impairment in AUD.

The Role of Addiction Treatment in Building Recovery Capital: Findings From 2022 Life in Recovery Survey in Flanders, Belgium

Introduction: This paper examines life experiences before and during addiction recovery in a large sample of treated and untreated persons in Flanders (Belgium). Methods: A total of 343 participants in recovery from alcohol and/or illicit drug problems (≥3 months) completed the 2022 ‘Life in Recovery’ survey online. Participants were categorized into four groups based on their engagement with treatment services: (1) unassisted recovery, (2) mutual aid support only, (3) formal treatment only, and (4) formal treatment and mutual aid support. The questionnaire was supplemented with open-ended questions about facilitators and barriers to recovery. Findings: Group comparisons revealed significant differences in the severity of dependence and living conditions (recovery strengths and barriers, SABRS) during addiction between those in recovery without treatment and the treatment groups. However, similarities in strengths, barriers, and quality of life during recovery were observed across all groups. Differences in barriers during recovery were attributed to variations in initial conditions rather than treatment engagement. The complementary qualitative analysis revealed that the four clusters experienced similar factors as facilitating and hindering recovery. Discussion: These findings suggest that while various pathways can lead to recovery, those involving formal treatment and mutual aid support may be particularly valuable for individuals facing greater initial barriers and fewer strengths during addiction, highlighting treatment as an important but not universally necessary source of recovery capital.

Alcohol-related cancer risk awareness and support for cancer warning labelling among adults in Estonia

ObjectivesThe aim of this study was to describe alcohol-related cancer risk awareness and examine sociodemographic and alcohol-related variance in attitudes towards implementation of cancer warning labelling on alcohol containers in Estonia. Study designNationally representative data from a 2022 cross-sectional survey (n = 2059) among the 15–74-year-old population in Estonia were used. MethodsDescriptive statistics on the prevalence of alcohol-related cancer risk awareness and support for the implementation of cancer risk warning labelling on alcohol containers are presented. Poisson regression analysis was used to investigate whether support for warning labelling varied by sociodemographic variables, individual alcohol consumption and cancer risk awareness indicators. ResultsStudy found that 73.2% of respondents associated alcohol consumption with increased cancer risk for one or more cancer sites, but implementation of alcohol cancer risk labelling was only supported by 54%. Women, younger age groups, non-Estonians and those with lower education level expressed higher support for warning labelling, whereas lower support was found among those with high-risk alcohol consumption. As expected, awareness of alcohol-related cancer risk and perceiving individual alcohol consumption as a cancer hazard were associated with support for warning labelling. ConclusionsThese findings emphasise the need for better communication of alcohol-related cancer risks as public awareness on the link between alcohol consumption and site-specific cancer risk was low. Increased awareness of alcohol as a cancer risk factor would potentially build public support for introducing cancer-risk warning labelling on containers of alcoholic drinks.

Impact of Keratins 8 and 18 Genetic Variants on the Severity of Alcoholic Liver Disease

Alcohol-related liver disease (ALD) affects ∼30% of heavy drinkers and is characterized by liver steatosis, fibrosis, and steatohepatitis. The aggregation of keratins 8 (KRT8) and 18 (KRT18) plays a key role in the formation of Mallory–Denk bodies, a hallmark of ALD. Circulating levels of KRT18 fragments are elevated during ALD, and several KRT8/18 genetic variants have been linked to an increased risk of liver disease. In this study, we explored the relationship between the histologic features of ALD and genetic variants of KRT8/18 in 106 severe patients with ALD from the Hôpitaux Universitaires de Genève. We found a significant over-representation of several KRT8 (rs2070910, rs137898974, rs1065306) and KRT18 (rs17120866, rs1492241) variants located in the noncoding regions of these genes. Increased circulating level of keratins 18 fragments were associated with rs17120866 and alcoholic hepatitis. The combination of several KRT18 variants appeared associated with a poorer prognosis. These results highlight the possible role of KRT18 variants in ALD.

Clinical characteristics of adults with alcohol dependence syndrome comorbid with antisocial personality disorder: a cross-sectional study.

Antisocial Personality Disorder (ASPD) is characterized by a pervasive pattern of disregard for and violation of the rights of others, typically emerging by age 15 years and involving behaviors such as deceitfulness, impulsivity, and aggressiveness. The present study sought to examine the prevalence of the comorbid ASPD in adult people with Alcohol Dependence Syndrome (ADS) and identify clinical characteristics associated with ASPD. A cross-sectional study of 100 consecutive subjects diagnosed with ADS was conducted. Subjects were examined between August 2023 and September 2023. Various assessments and questionnaires were employed, including the Montreal Cognitive Assessment (MoCA), Alcohol Use Disorders Identification Test (AUDIT), and Structured Clinical Interview for DSM-IV (SCID-II). A computed tomography (CT) scan of the brain was performed on 47.5% participants. Out of the 100 individuals screened for the study, 20 were excluded. The study found that 35% of the examined study participants had a comorbid ASPD. Individuals with both ADS and ASPD were more likely to be younger, started drinking at an earlier age, had higher hospitalization rates, and scored higher on the AUDIT test (all P < 0.05%). Also, they had lower education levels, higher rates of unemployment, and lower marriage rates (all P < 0.05%). In addition, they reported more family members with ADS, incarceration, or mental illness and a higher frequency of traumatic experiences (all P < 0.05%). Depression, anxiety, stress (all P < 0.05%), and sleep problems (P = 0.058) were correlated with ASPD. Participants with the comorbid ASPD had lower MoCA scores (P = 0.046) and struggled with attention and linguistic subtests compared to subjects with ADS only. The study highlights the high prevalence of comorbid ASPD in participants with ADS, shedding light on their demographic and psychometric characteristics. Individuals with the comorbid ASPD are more likely to face cognitive deficits, especially in linguistic and attention-related tasks. The findings underline the importance of considering the comorbidity of ASPD in ADS subjects. The study implies that the understanding of the associated risk factors can aid in developing more targeted treatment interventions.

A - 22 Effects of Gender on the Relationship between Coping Styles and Executive Functioning in Alcohol Use Disorders

Abstract Objective Executive functioning (EF) and coping styles are important factors likely to influence risk and resilience to relapse following Alcohol Use Disorder (AUD) treatment. This study aims to evaluate EF and coping as independent predictors of relapse and the interplay between these two constructs by treatment outcome group and gender differences. Methods 23 females and 59 males in AUD residential treatment programs completed self-report questionnaires, a neuropsychological battery, and were followed for six months to determine treatment outcome. A logistic regression analysis was performed to evaluate coping (Brief COPE Inventory) and EF (Delis-Kaplan Executive Function System, Color-Word Interference Test, CWIT; inhibition and switching conditions) variables as predictors of relapse status. Significant predictors were evaluated by group status and gender to understand the association between coping and EF using Pearson correlation within each group. Results Gender (B = 8.6, p = 0.032), two coping (self-distraction (B = 2.3, p = 0.051) and humor (B = 1.9, p = 0.051)) and two EF (CWIT inhibition (B = 0.5, p = 0.007) and CWIT switching (B = 1.9, p = 0.006)) variables resulted in 85.4% overall classification accuracy. Correlations between these coping and EF, when evaluated by treatment group and gender, revealed significant gender-specific associations only among the relapse groups: self-distraction and CWIT inhibition (r = 0.379) in females and humor and CWIT inhibition (r = 0.242) in males. Conclusion Overall, EF and coping styles have independent predictive value for determining relapse risk in individuals with AUD. Poor EF skills may inhibit an individual’s ability to engage in appropriate coping during times of emotional distress. Understanding gender differences in relation to these dynamic relationships is essential for creating supportive and effective psychosocial interventions.

Deployment and combat experiences and their impact on partner substance use

Despite burgeoning evidence of the negative effects of service experiences on service members’ spouses/partners, limited research has examined these effects in the context of substance use. Additionally, a strong literature demonstrates the protective role relationship satisfaction can play for health-related outcomes. The goal of the present research is to examine relations between service experiences (e.g., deployment, combat exposure) and partner substance use, as well as how relationship satisfaction may buffer these effects. Data from 275 civilian partners were drawn from Operation: SAFETY (Soldiers And Families Excelling Through the Years), a longitudinal study examining health among U.S. Army Reserve/National Guard (USAR/NG) soldiers and partners. Analyses examined relations between soldier service history (baseline) and civilian partner alcohol/drug use (2-year follow-up), as well as interactions with relationship satisfaction. Models controlled for civilian partner sex and age and soldiers’ self-reported posttraumatic stress disorder symptoms and substance use. Results revealed interactions between service experiences and partner satisfaction for models predicting alcohol consumption and heavy drinking. Greater relationship satisfaction mitigated overall alcohol consumption and heavy drinking frequency among partners of soldiers with two or more deployments and among partners of soldiers with greater combat exposure. Soldier service experiences were unrelated to civilian partner drug use. The effects of deployment and combat exposure extend beyond the service member to negatively influence civilian partner alcohol consumption and heavy drinking, with relationship satisfaction buffering these risks. Interventions that assist USAR/NG soldiers and spouses in strengthening their relationships may also help protect against spouse substance use related to soldier service experiences.

B - 18 Effect of Automatic Approach Tendency on Neural Dynamics in Heavy Drinkers: an ERP Study

Abstract Objective Automatic alcohol approach/avoidance tendencies play a major role in alcohol dependence, but associated interventions are seen to have negligible effects on relapse prevention due to a limited understanding and lack of focus on modulating associated neuro-cognitive mechanisms. The current work explores the automatic tendencies-based behavioral and event-related potential (ERP) differences and probes into the neurocognitive processes and responsible brain regions. Method The study was conducted in a laboratory setting on 19 heavy drinkers (Alc) and 20 non-drinkers (NAlc) males recruited using snowball sampling, where participants performed an Alcohol Approach-Avoidance Task (AAT), a task for assessing/categorizing participants with automatic approach (AAppr) and avoidance (AAvoi) tendencies toward alcohol during EEG recording. A 2 (group: Alc, NAlc) x 2 (automatic tendencies: approach, avoidance) ANOVA for behavioral outcomes and ANOVA with planned contrasts for Alc and NAlc, and AAppr and AAvoi groups comparisons were performed on early, mid, and late ERP measures. Results The group-tendency interaction significantly influenced behavioral AAT scores. At the neural level, the Alc and NAlc group differences were present at the occipital, parietal, and frontal sites. However, the AAppr and AAvoi group differences were only present at the frontal regions, and prominent for N100–200 and N350–450 amplitudes at the F4 electrode, an electrode sitting over the right dorsolateral prefrontal cortex (dLPFC), responsible for modulating attention, response inhibition, and decision-making processes. Conclusion The results clarify the role of frontal and right dLPFC areas in driving the differences in automatic tendencies by significantly suppressing the neural responses in heavy drinkers with approach but not avoidance tendencies.

A - 103 Exploring the Diagnostic Criteria for Alcohol-Related Dementia: a Case Study

Abstract Objective Excessive and chronic alcohol use can cause structural/functional abnormalities in the brain, including cognitive impairment (CI) (Harper, 2009). Despite these established risks, alcohol-related dementia (ARD) has received little recognition, mainly due to lack of a distinct pathophysiological profile. Through a case differential approach (concussion vs. ARD), the authors aim to clarify diagnostic criteria for ARD. Methods A 56-year-old right-handed male presented to the emergency room after fall with head strike (no loss of consciousness) with alcohol withdrawal delirium. Symptoms of cerebellar ataxia and CI of 6-month duration were noted. Past medical history was significant for alcohol use (four standard units per day), hyperlipidemia, tobacco use, and depression/anxiety. Neuroimaging revealed cerebral atrophy and chronic small vessel ischemic disease. A neuropsychological evaluation (NPE) was conducted 18 days post-fall. Results NPE revealed relative weaknesses in working memory, complex attention, and visual abstraction. Impairments were noted in visuospatial organization/planning, processing speed, basic attention, verbal fluency, and verbal memory. Motor examination was evident for intention tremor. Conclusion Brain changes associated with ARD include volume loss, altered glucose metabolism, reduced neuronal density, changes in frontal lobe function, and white matter loss. In contrast, individuals affected by concussions may encounter challenges with attention/concentration, processing speed, and working memory. Distinguishing a clear diagnostic profile for ARD is difficult due to high rates of concomitant concussion in this population. The patient’s deficits exceed those expected due to concussion alone, with an anticipated cognitive recovery timeframe of 7–14 days (Iverson, 2006). Furthermore, neuroimaging and NPE results support the diagnostic hypothesis of ARD.