CORRELATION BETWEEN INHIBITION, WORKING MEMORY AND DELIMITED FRONTAL AREA BLOOD FLOW MEASURED BY 99mTc-BICISATE SPECT IN ALCOHOL-DEPENDENT PATIENTS

Abstract

Recently detoxified non-neurological alcoholic patients appear to be impaired in cognitive tasks measuring inhibitory processes as well as working memory (involving storage and manipulation of information). The aim of this study was to investigate in alcoholic participants the relationship between these two cognitive functions and regional cerebral blood flow (rCBF) studied at rest in regions of interest selected on the basis of recent PET studies which explored inhibitory and working memory in normal subjects. Twenty non-neurological alcoholic patients and 20 normal volunteers were selected for a neuropsychological exploration, including assessment of inhibition processes (by means of the Hayling test) and working memory (by means of the Alpha-span task). rCBF of alcoholics was also evaluated with a semi-quantitative method using a 99mTc-Bicisate single photon emission computed tomography (SPECT) procedure. Alcoholic patients performed worse than controls in the alphabetical condition of the Alpha-span task (involving manipulation and storage of information), and on the Hayling test. Significant correlation emerged between inhibition performance and both the bilateral inferior (left BA 47, r = -0.40; right BA 47, r = -0.599) and median frontal gyrus (left BA 10, r = -0.55; right BA 10, r = -0.59), but not with the region of reference (occipital/cerebellum, r = -0.13). Coordination of storage and manipulation was correlated with bilateral median frontal (left BA 10/46, r = -0.50; right BA 10/46, r = -0.45), but not with bilateral parietal area (left BA 7, r = -0.12, right BA 7, r = -0.18). These results suggest a relationship between inhibition and working memory deficits in alcoholic patients, and regional rCBF measured in frontal areas. Clinical implications of these data related to alcohol relapse are discussed.

Brain Morphometry and Cognitive Performance in Detoxified Alcohol-Dependents with Preserved Psychosocial Functioning

“…Nevertheless, relationships between brain function deficits and neuropsychological impairments have been previously reported in neurologically normal alcoholdependent subjects (Adams et al, 1993;Dao-Castellana et al, 1998;Noel et al, 2001a). For example, Dao-Castellana et al (1998) observed in a PET study a significant relationship between the extent of left dorsolateral and medial prefrontal hypometabolism and lower reaction times in the Stroop test and lower verbal fluency performance.…”

“…The selective alteration of executive functions, such as planning or problem solving, has been reported even in neurologically normal alcoholic patients (Oscar-Berman et al, 1997). The signs of cognitive dysfunction may occur up to 10 years before alcohol-related neurological disorders appear (Tuck and Jackson, 1991), and it has been suggested that chronic alcohol consumption may lead to early effects on cognitive operations that critically rely on frontal lobe function (Adams et al, 1993;Noel et al, 2001a).…”

Flashbulb memories for Paris attacks in an alcohol-abstinent patient

“…Alcohol-dependence has been associated with memory compromise, a compromise that has been observed for working memory [1][2][3][4][5], for memory for verbal or nonverbal stimuli [6][7][8], and for source memory, i.e., the ability to remember the context in which an event occurred [9,10]. Interestingly, autobiographical memory, or memory for personal experiences, has been also found to be compromised in alcohol-dependence.…”

Avaliação neurocognitiva no abuso e dependência do álcool: implicações para o tratamento

“…There were also found deficits in the executive functions (behavioral inhibition) and in working memory, which is related to a system involving the short-term memory, responsible for the maintenance and manipulation of information in the mind for the accomplishment of complex cognitive tasks. 2 The alterations found in alcohol-dependent subjects seem to represent diffuse brain damage and although they improve substantially during withdrawal, some deficits remain even years after the last alcohol ingestion. 11 Subjects who use chronically alcohol, although being neurologically asymptomatic, may present dysfunctions in prefrontal lobe areas 12 ( Figure 1), implying neuropsychological deficits in verbal fluency (expressive language) and in inhibitory control (difficulty to suppress habitual and automatic responses instead of more elaborated competitive behaviors).…”

“…3 11 Besides, patients with cognitive and neuroimaging alterations, mainly in frontal brain regions, tend to have a worse prognosis, associated with a higher number of relapses during treatment. 20 One study by Noël et al 2 assessed 20 alcohol-dependent subjects, comparing them to 20 normal volunteers, in exams which included neuropsychological tests, involving the functions of inhibitory control, working memory, abstraction capability and verbal memory, as well as analysis of brain function through SPECT. Patients were at the end of a detoxification program, with a mean of 18.8 days of withdrawal.…”