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Decreased Verbal Learning but not Recognition Performance in Alcohol-dependent Individuals During Early Abstinence

Published online by Cambridge University Press:  13 June 2014

Isolde Daig*
Affiliation:
Institute of Medical Psychology, Charité – University Medical Center, Berlin, Luisenstraße 57, 10117 Berlin, Germany
Richard Mahlberg
Affiliation:
Clinic of Psychiatry, Addiction, Psychotherapy and Psychosomatics, Klinik am Europakanal, Erlangen, Am Europakanal 71, 91056 Erlangen, Germany
Julia Stethin
Affiliation:
Department of Psychology, University of Potsdam, Karl Liebknecht Straße 24/25, 14476 Potsdam OT Golm, Germany
Franziska Schroeder
Affiliation:
Department of Psychology, University of Potsdam, Karl Liebknecht Straße 24/25, 14476 Potsdam OT Golm, Germany
Jana Wrase
Affiliation:
Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – University Medical Center, Berlin, Charitéplatz 1, 10117 Berlin, Germany
Nina Knoll
Affiliation:
Institute of Medical Psychology, Charité – University Medical Center, Berlin, Luisenstraße 57, 10117 Berlin, Germany
Tom Bschor
Affiliation:
Department of Psychiatry and Psychotherapy, Jewish Hospital Berlin, Heinz Galinski Straße 1, 13347 Berlin, Germany
Guenter Esser
Affiliation:
Department of Psychology, University of Potsdam, Karl Liebknecht Straße 24/25, 14476 Potsdam OT Golm, Germany
Andreas Heinz
Affiliation:
Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – University Medical Center, Berlin, Charitéplatz 1, 10117 Berlin, Germany
Thorsten Kienast
Affiliation:
Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – University Medical Center, Berlin, Charitéplatz 1, 10117 Berlin, Germany
*
Correspondence: Isolde Daig, Institute of Medical Psychology, Charité – University Medical CenterBerlin, Luisenstraße 57, 10117 Berlin, Germany, Email: isolde.daig@charite.de

Abstract

Objective: Alcoholism ultimately leads to impairment of memory and other cognitive functions. This can interfere with treatment, if cognitively impaired alcohol-dependent individuals have difficulties recalling and implementing skills acquired during therapy. We investigate if alcohol-dependent individuals without clinically apparent withdrawal symptoms may still be impaired in higher-order cognitive functions.

Methods: Thirty-four alcohol-dependent patients and 20 matched healthy controls were tested with the Verbal Learning and Memory Test which includes seven measurement points. The test comprises free recall, free recall after distraction and after 30 minute delay, and a word recognition task. Testing was performed between day seven and day 10 after the beginning of abstinence, when clinical withdrawal symptoms had ceased.

Results: Compared to healthy controls, alcohol-dependent patients performed worse in free recall after delay, but not in word recognition. Healthy controls showed a more linear progression of improvement in verbal memory performance. Overall, alcohol-dependent individuals showed reduced verbal learning efficiency. The extent of impaired recall after distraction was positively associated (one-tailed test) with history of delirium (r=0.34, p=0.04), seizures (r=0.46, p=0.01), and years since diagnosis for alcohol dependency (r=0.39, p=0.01).

Conclusions: Our results provide evidence that unmedicated alcohol-dependent patients without obvious withdrawal symptoms had impaired verbal recall, but normal recognition performance, at seven to 10 days after onset of abstinence. This deficit may deteriorate treatment outcomes due to poorer implementation of skills newly-learned during this time period.

Type
Original Paper
Copyright
Copyright © Cambridge University Press 2012

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References

1.Parsons, OA. Neurocognitive Deficits in Alcoholics and Social Drinkers: A Continuum? Alcohol Clin Exp Res 1998; 22: 954–61.Google ScholarPubMed
2.Davies, SJC, Pandit, SA, Feeney, A, Stevenson, BJ, Kerwin, RW, Nutt, DJ, et al.Is there cognitive impairment in clinically “healthy” abstinent alcohol dependence? Alcohol Alcoholism 2005; 40: 498503.CrossRefGoogle ScholarPubMed
3.Johnson, I. Outcome of Alcoholism in Old Age. Ir J Psych Med 2001; 18(4): 125–28.CrossRefGoogle ScholarPubMed
4.Tivis, R, Beatty, WW, Nixon, SJ, Parsons, OA. Patterns of cognitive impairment among alcoholics: are there subtypes? Alcohol Clin Exp Res 1995; 19: 496500.CrossRefGoogle ScholarPubMed
5.Uekermann, J, Daum, I, Schlebusch, P, Wiebel, B, Trenckmann, U. Depression and cognitive functioning in alcoholism. Addiction 2003; 98: 1521–29.CrossRefGoogle ScholarPubMed
6.Seifert, J, Seeland, I, Borsutzky, M, Passie, T, Rollnik, JD, Wiese, B, et al.Effects of acute alcohol withdrawal on memory performance in alcohol-dependent patients: a pilot study. Addict Biol 2003; 8: 7580.CrossRefGoogle ScholarPubMed
7.Pitel, AL, Beaunieux, H, Witkowski, T, Vabret, F, Guillery-Girard, B, Quinette, P, et al.Genuine episodic memory deficits and executive dysfunctions in alcoholic subjects early in abstinence. Alcohol Clin Exp Res 2007; 31: 1169–78.CrossRefGoogle ScholarPubMed
8.Bondi, MW, Drake, AI, Grant, I. Verbal learning and memory in alcohol abusers and polysubstance abusers with concurrent alcohol abuse. J Int Neuropsych Soc 1998; 4: 319–28.CrossRefGoogle ScholarPubMed
9.Saxton, J, Munro, CA, Butters, MA, Schramke, C, McNeil, MA. Alcohol, dementia, and Alzheimer's disease: comparison of neuropsychological profiles. J Geriatr Psych Neur 2000; 13: 141–49.CrossRefGoogle ScholarPubMed
10.McGaugh, JL. Memory-a century of consolidation. Science 2000; 287: 248–51.CrossRefGoogle ScholarPubMed
11.Nielson, KA, Powless, M. Positive and negative sources of emotional arousal enhance long-term word-list retention when induced as long as 30 min after learning. Neurobiol Learn Mem 2007; 88: 4047.CrossRefGoogle Scholar
12.Sherer, M, Nixon, SJ, Parsons, OA, Adams, RL. Performance of alcoholic and brain-damaged subjects on the Luria Memory Words test. Arch Clin Neuropsych 1992; 7: 499504.CrossRefGoogle ScholarPubMed
13.Kelleher, M, O'Brien, S. An audit of admissions to an acute psychiatric unit. Ir J Psych Med 2001; 18(4): 132–36CrossRefGoogle Scholar
14.Noel, X, Paternot, J, Van der Linden, M, Sferrazza, R, Verhas, M, Hanak, C, et al.Correlation between inhibition, working memory and delimited frontal area blood flow measure by 99mTc-Bicisate SPECT in alcohol-dependent patients. Alcohol Alcoholism 2001; 36: 556–63.CrossRefGoogle ScholarPubMed
15.Moselhy, HF, Georgiou, G, Kahn, A. Frontal lobe changes in alcoholism: a review of the literature. Alcohol Alcoholism 2001; 36: 357–68.CrossRefGoogle ScholarPubMed
16.Helmstaedter, C, Lendt, M, Lux, S. Verbaler Lern- und Merkfähigkeitstest. Göttingen: Beltz Test GmbH, 2001.Google Scholar
17.Wetterling, T, Kranitz, RD, Besters, B, Fischer, D, Zerfass, B, John, U, et al.A new rating scale for the assessment of the alcohol-withdrawal syndrome (AWS scale). Alcohol Alcoholism 1997; 32: 753760.CrossRefGoogle ScholarPubMed
18.Sullivan, EV, Marsh, L, Mathalon, DH, Lim, KO, Pfefferbaum, A. Relationship between alcohol withdrawal seizures and temporal lobe white matter volume deficits. Alcohol Clin Exp Res 1996; 20: 348–54.CrossRefGoogle ScholarPubMed
19.Nixon, SJ, Kujawski, A, Parsons, OA, Yohman, JR. Semantic (verbal) and figural memory impairment in alcoholics. J Clin Exp Neuropsychol 1987; 9: 311–22.CrossRefGoogle ScholarPubMed
20.Sullivan, EV, Shear, PK, Zipurksy, RB, Sagar, HJ. Patterns of Content, Contextual, and Working Memory Impairments in Schizophrenia and Nonamnesic Alcoholism. Neuropsychology 1997; 11: 195206.CrossRefGoogle ScholarPubMed
21.Müller, GE, Pilzecker, A. Experimentelle Beiträge zur Lehre vom Gedächtnis. Zeitschrift für Psychologie und Sinnesphysiologie (Ergänzungsband) 1900; 1: 1300.Google Scholar
22.Hildebrandt, H, Brokate, B, Eiling, P, Lanz, M. Response shifting and inhibition, but not working memory, are impaired after long-term heavy alcohol consumption. Neuropsychology 2004; 18: 203–11.CrossRefGoogle Scholar
23.Sullivan, EV, Rosenbloom, MJ, Pfefferbaum, A. Pattern of motor and cognitive deficits in detoxified alcoholic men. Alcohol Clin Exp Res 2000; 24: 611–21.CrossRefGoogle ScholarPubMed
24.Tsai, GC, Gastfriend, DR, Coyle, JT. The glutamatergic basis of human alcoholism. Am J Psychiat 1995; 152: 332–40.Google ScholarPubMed
25.Inder, WJ, Joyce, PR, Ellis, MJ, Evans, MJ, Livesey, JH, Donald, RA. The effects of alcoholism on the hypothalamic-pituitary-adrenal axis: interaction with endogenous opioid peptides. Clinical Endocrinology (Oxford) 1995; 43: 283–90.CrossRefGoogle ScholarPubMed
26.Abi-Dargham, A, Krystal, JH, Anjilvel, S, Scanley, BE, Zoghbi, S, Baldwin, RM, et al.Alterations of benzodiazepine receptors in type II alcoholic subjects measured with SPECT and [123I]iomazenil. Am J Psychiat 1998; 155: 1550–55.CrossRefGoogle ScholarPubMed
27.Oscar-Berman, M, Marinkovic, K. Alcoholism and the brain: an overview. Alcohol Res Health 2003; 27: 125–33.Google ScholarPubMed
28.Kiefer, F, Wiedemann, K. Neuroendocrine pathways of addictive behaviour. Addiction Biol 2004; 9: 205–12.CrossRefGoogle ScholarPubMed
29.Heinz, A, Siessmeier, T, Wrase, J, Buchholz, HG, Gründer, G, Kumakura, Y, et al.Correlation of alcohol craving with striatal dopamine synthesis capacity and D2/3 receptor availability: a combined [18F]DOPA and [18F]DMFP PET study in detoxified alcoholic patients. Am J Psychiat 2005; 162: 1515–20.CrossRefGoogle ScholarPubMed
30.Almeida, OP, Garrido, GJ, Alfonso, H, Hulse, G, Lautenschlager, NT, Hankey, GJ, Flicker, L. 24-month effect of smoking cessation on cognitive function and brain structure in later life. Neuroimage 2011; 55(4): 14801489.CrossRefGoogle ScholarPubMed
31.Durazzo, TC, Fryer, SL, Rothlind, JC, Vertinski, M, Gazdzinski, S, Mon, A, Meyerhoff, DJ. Measures of learning, memory and processing speed accurately predict smoking status in short-term abstinent treatment-seeking alcoholics. Alcohol Alcohol 2010; 45(6): 507513.CrossRefGoogle Scholar
32.Miller, WR, Wilbourne, PL, Hettema, JE. What works? A summary of alcohol treatment outcome research. In Hester, R. K. & W. K., Miller (Eds.), Handbook of alcoholism treatment approaches: effective alternatives, Vol. 3. Boston: Allyn and Bacon, 2003: 213–36.Google Scholar
33.Aharonovich, E, Amrhein, PC, Bisaga, A, Nunes, EV, Hasin, DS. Cognition, Commitment Language, and Behavioral Change Among Cocaine-Dependent Patients, Psychol Addict Behav 2008; 4: 557–62.CrossRefGoogle Scholar
34.Sinha, R. The role of stress in addiction relapse. Curr Psych Rep 2007; 9: 388–95.CrossRefGoogle ScholarPubMed
35.James, A, Edwards, EScreening for excessive drinkers in a Hampshire general practice. Ir J Psych Med 2002; 19(1): 1315CrossRefGoogle Scholar
36.Godding, PR, Fitterling, JM, Schmitz, JM, Seville, JL, Parisi, SA. Discriminative Utility of a Brief Cognitive Status Assessment With Alcoholics and the Impact of Cognitive Status on Acquisition of Treatment-Relevant Information. Psychol Addict Behav 199; 6(1): 3440.CrossRefGoogle Scholar
37.Mann, K, Günther, A, Stetter, F, Ackermann, K. Rapid recovery from cognitive deficits in abstinent alcoholics: a controlled test-retest study. Alcohol Alcoholism 1999; 34: 567–74.CrossRefGoogle ScholarPubMed