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

Abstract

Alcohol-related cognitive impairment (ARCI) is highly prevalent among patients with alcohol dependence. Although it negatively influences treatment outcome, this condition is underdiagnosed and undertreated. The aim of this systematic review is to investigate the existing evidence regarding both cognitive and pharmacological interventions for ARCI. We systematically reviewed PubMed, Scopus and Science direct databases up to May 2019 and followed the PRISMA guidelines. The quality of the studies was assessed using the Jadad Scale. Twenty-six studies were eligible for inclusion (14 referring to neuropsychological interventions and 12 to pharmacological treatments). Among neuropsychological interventions, computerised treatments, errorless learning and component method showed positive effects on working memory, memory measures and general cognitive function. On the other hand, thiamine, memantine and methylphenidate improved working memory, long-term memory and general cognitive function. Nevertheless, these studies have several limitations, such as small sample size, lack of replication of the results or low specificity of the interventions. Therefore, no gold-standard intervention can yet be recommended for clinical practice, and further research based on promising strategies (e.g. digital interventions, thiamine) is required.

Exploring the types of therapeutic and psychosocial interventions accessed by people with a diagnosis of alcohol related brain damage (ARBD): A qualitative study

“…Bates et al (2013) assert that neurocognitive impairments ranging from mild to severe are prevalent in most people with AUD but the de cits can be minimal, transient and even improve with sustained abstinence. A systematic review by Caballeria et al (2020) highlighted studies that have looked into the bene ts of what is called the component method which is a rehabilitative strategy of breaking down complex tasks into smaller and easier to navigate components and small improvements in visuospatial skills were noted after one month of abstaining from alcohol. However, evidence in earlier studies had already indicated that impairment in this domain improved rapidly with abstinence (Sullivan 2008, Rosenbloom et al 2000.…”

Walnut protein hydrolysates ameliorate alcohol-induced cognitive impairment (AICI) by alleviating oxidative stress and inflammation in the brain and improving hippocampal synaptic plasticity in Sprague–Dawley rats

“…Moreover, previous reports revealed neuronal apoptosis when an individual was exposed to chronic alcohol abuse. 7,29,30 Therefore, it can be postulated that this desirable amelioration of WPH of neuronal impairment might result from the stimulation of neurogenesis.…”

“…Numerous pieces of evidence have revealed the stimulation by alcohol of the release of reactive oxygen species (ROS) and inflammatory cytokines in brain tissues, which certainly leads to oxidative stress and neuroinflammation. 6–9 As such, a more comprehensive understanding of the role of oxidative stress and neuroinflammation in mediating the development of AICI is urgently needed. Generally, the excessive accumulation of ROS is the initial response of brain tissue to chronic alcohol exposure and a subsequently enhanced release of inflammatory cytokines such as interleukin (IL)-6 and tumor necrosis factor (TNF)-α is observed.…”

Identifying Alcohol Use Disorder With Resting State Functional Magnetic Resonance Imaging Data: A Comparison Among Machine Learning Classifiers

“…Alcohol consumption can create a series of health problems in important organs in the body such as the liver (Axley et al, 2019) and the brain (Rao and Topiwala, 2020). A series of neurocognitive problems are known to manifest in individuals with AUD (Caballeria et al, 2020) that might persist even after long periods of abstinence. These impairments are related to structural and functional effects of alcohol in the brain.…”