Response Shifting and Inhibition, but Not Working Memory, Are Impaired After Long-Term Heavy Alcohol Consumption.

Department of Neurology, Municipal Hospital of Bremen, Bremen, Germany.
Neuropsychology (Impact Factor: 3.27). 05/2004; 18(2):203-11. DOI: 10.1037/0894-4105.18.2.203
Source: PubMed


Chronic alcohol abuse leads to cognitive deficits. The authors investigated whether a systematic increase of interference in a 2-back working memory paradigm would lead to cognitive deficits in alcoholic participants and compared their performance in such a task with that in an alternate-response task. Twenty-four nonamnesic and nondemented alcohol abuse (AA) patients and 12 patients with Korsakoff's syndrome (KS) were compared with a control group. AA patients were impaired in the alternate-response task but not in working memory interference resolution. KS patients performed worse than the AA patients and the controls in both tasks. The neurotoxic side effects of alcohol therefore lead to a specific deficit in alternating between response rules but not in working memory, independently of whether the working memory task involves interference resolution or not.

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    • "Moreover, explorations testing global dysexecutive symptoms (Van Oort and Kessels, 2009; Maharasingam et al., 2013) showed higher impairments in KS than ADS. However, very few studies directly compared ADS and KS performances (e.g., Brokate et al., 2003; Hildebrandt et al., 2004; Oscar-Berman et al., 2004; Pitel et al., 2008) and these investigations used tasks simultaneously involving several EF. Moreover, as each study focused on a limited range of tasks, the current data do not offer a comparison of the deficit across EF. "
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    ABSTRACT: Korsakoff syndrome (KS) is a neurological state mostly caused by alcohol-dependence and leading to disproportionate episodic memory deficits. KS patients present more severe anterograde amnesia than Alcohol-Dependent Subjects (ADS), which led to the continuum hypothesis postulating a progressive increase in brain and cognitive damages during the evolution from ADS to KS.This hypothesis has been extensively examined for memory but is still debated for other abilities, notably executive functions (EF). EF have up to now been explored by unspecific tasks in KS, and few studies explored their interactions with memory. Exploring EF in KS by specific tasks based on current EF models could thus renew the exploration of the continuum hypothesis. This paper will propose a research program aiming at: (1) clarifying the extent of executive dysfunctions in KS by tasks focusing on specific EF subcomponents; (2) determining the differential EF deficits in ADS and KS; (3) exploring EF-memory interactions in KS with innovative tasks. At the fundamental level, this exploration will test the continuum hypothesis beyond memory. At the clinical level, it will propose new rehabilitation tools focusing on the EF specifically impaired in KS.
    Full-text · Article · Jul 2014 · Frontiers in Human Neuroscience
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    • "Results from neuroimaging studies are likely to support this model, given that those 3 processes, although associated with relatively distinct prefrontal and parietal brain areas, have also shown common activated areas (Collette et al., 2005; McNab et al., 2008). While data concerning updating processes in AD individuals seem controversial (Hildebrandt et al., 2004; Pitel et al., 2009), impairment in the 2 other processes has been widely documented. Currently abstinent AD individuals exhibit impaired abilities for performing neuropsychological tests designed to assess inhibition and set shifting processes, such as the Wisconsin Card Sorting Test (WCST), the Stroop color–word test, and the Trail-making test (TMT) (Davies et al., 2005; Oscar-Berman et al., 2009; Pitel et al., 2009; Ratti et al., 2002; Zinn et al., 2004). "
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    ABSTRACT: Background: Executive function (EF) impairment in alcohol dependence (AD) has been related to the toxic effects of alcohol on frontal lobes. However, this impairment could be partially present before the onset of the disease and might constitute a vulnerability factor. Although a considerable body of research has investigated executive functioning among AD patients, much less attention has been directed toward high-risk individuals. Most studies were carried out among children or adolescents, and very few were conducted in adults. The aim of this study was to examine EF in a group of adult offspring of AD individuals. Methods: One hundred and fifty-five nonalcoholic adults with (family history positive [FHP]) or without (family history negative [FHN]) family history of AD were included in the study. All participants were screened for past and current psychiatric diagnoses, and alcohol, tobacco, and other substance use. They were compared on self-rated impulsiveness using the Barratt Impulsiveness Scale-11 (BIS-11) and EF using a neuropsychological test battery. Results: Group comparison revealed that FHP participants had significantly higher BIS-11 scores than the FHN participants, while neuropsychological examination revealed lower EF scores for FHP participants. Hierarchical regression analysis revealed that the number of AD family members was a predictor of EF results, whereas impulsiveness was not. Conclusions: Nonalcoholic adult offspring of AD individuals showed increased impulsiveness and decreased EF, suggesting weakness of 2 distinct neurobehavioral decision systems. Findings support evidence that EF weaknesses may qualify as a suitable endophenotype candidate for AD.
    Full-text · Article · Dec 2012 · Alcoholism Clinical and Experimental Research
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    • "In individuals with alcoholism (and abstinent for a period ranging from several days – (Pitel et al., 2007) – up to several months – (Munro et al., 2000) and even years – (Brandt et al., 1983)), EM disorders have been identified with the help of psychometric tasks such as the Wechsler Memory Scale (e.g., Glenn and Parsons, 1992; Fama et al., 2004), the learning of face-name associations (e.g., Beatty et al., 1995; Tivis and Parsons, 1995), lists of words (e.g., Brokate et al., 2003; Hildebrandt et al., 2004), and even addresses and stories (Fama et al., 2009). However, the underlying processes for this EM impairment and related-brain structures remain unclear (see the critical view by Pitel et al., 2007a). "
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    ABSTRACT: Individuals with alcoholism commonly exhibit impaired performance on episodic memory tasks. However, the contribution of their impaired executive functioning to poor episodic memory remains to be clarified. Thirty-six recently detoxified and sober asymptomatic alcoholic men and 36 matched non-alcoholic participants were tested for processing speed, prepotent response inhibition, mental flexibility, coordination of dual-task and a verbal episodic memory task. Compared with non-alcoholic individuals, the alcoholic patients showed impaired executive functions combined with below normal performance on both free and delayed recall. In contrast, processing speed, cued recall and recognition were preserved. Regression analyses revealed that 47% of alcoholics' episodic memory's free recall performance was predicted by mental flexibility and that 49% of their delayed recall performance was predicted by mental flexibility, manipulation of dual-task and prepotent response inhibition. Regarding participants' executive predictors of episodic memory performance, the slopes of β coefficients were significantly different between the two groups, with alcoholics requiring more their executive system than non-alcoholics. Once detoxified, alcoholic patients showed episodic memory deficits mainly characterized by impaired effortful (executive) processes. Compared with controls, patients used effortful learning strategies, which are nonetheless less efficient.
    Full-text · Article · Feb 2012
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