Changes in Neuropsychological Status during the Initial Phase of Abstinence in Alcohol Use Disorder: Neurocognitive Impairment and Implications for Clinical Care

Abstract

After completing acute detoxification, almost all participants (93%) were clinically impaired in at least one of the five cognitive domains at residential treatment entry, with one third of the sample impaired on ≥3 domains. Ten days later, 71% remained clinically impaired in at least one of five cognitive domains, with 29% of the sample impaired on ≥3 domains. Significant improvement over the 10-day period was observed for immediate memory, visuospatial abilities, and overall cognitive functioning. Clinical significance of these changes is also reported. Conclusions/Importance: The results from this study help to characterize cognitive functioning in terms of neurocognitive impairment. A brief period of abstinence begins to ameliorate neuropsychological deficits, but many individuals remain cognitively impaired throughout treatment. Implications for treatment are discussed.

<p>Cognitive Impairments in Early-Detoxified Alcohol-Dependent Inpatients and Their Associations with Socio-Demographic, Clinical and Psychological Factors: An Exploratory Study</p>

“…40,42 These cognitive functions are fundamental for AUD patients to benefit from psychosocial treatments during recovery because CBT and motivational interventions require preserved cognitive functions to be effective. 8,67,68 Our results showed that 70.73% of the total sample had impaired performance on at least one test of the neuropsychological battery items. These findings are in line with a study which found that, after completing acute detoxification, almost all participants (93%) were clinically impaired in at least one of the five cognitive domains at entry to residential treatment and 71% remained clinically impaired after 10 days.…”

“…These findings are in line with a study which found that, after completing acute detoxification, almost all participants (93%) were clinically impaired in at least one of the five cognitive domains at entry to residential treatment and 71% remained clinically impaired after 10 days. 68 This means that abstinence has a relevant role for neuropsychological functioning, but it is not the only factor since some individuals remained cognitively impaired.…”

“…These cognitive functions are fundamental for AUD patients to benefit from psychosocial treatments during recovery because CBT and motivational interventions require preserved cognitive functions to be effective. 8 , 67 , 68 …”

“…First, although several studies in this specific clinical population used similar numbers, the sample size is quite small and only limited quantitative analyses were performed since the main focus was to describe qualitatively the cognitive deficits in patients undergoing treatment for AUD. 12 , 13 , 68 , 79 However, this represents an exploratory study and further research are needed to increase the validity of the results. Second, this study is cross-sectional, with a single neuropsychological assessment of early-detoxified patients; it would be useful to use a longitudinal perspective in order to study cognitive changes over time after detoxification.…”

A systematic review of treatments for alcohol-related cognitive impairment: lessons from the past and gaps for future interventions

“…Despite those severe forms, mild to moderate neurocognitive deficits are prevalent among patients with alcohol use disorder, with an estimated proportion of 50–70% presenting some degree of impairment (Bates et al, 2013). Even though for most of the patients many of the neuropsychological deficits related to heavy alcohol use are minimal or transient (Bates et al, 2013) and improve with sustained abstinence (Mulhauser, Weinstock, Ruppert, & Benware, 2018; Ridley et al, 2013; Ros-Cucurull et al, 2018; Stavro et al, 2013), in some cases, deficits are clinically severe and can persist (Hayes et al, 2016; Sachdeva et al, 2016). Nevertheless, the different cognitive functions do not recover homogeneously (Ioime et al, 2018; Mulhauser et al, 2018; Ros-Cucurull et al, 2018).…”