Cognitive Function in Patients With Alcoholic and Nonalcoholic Chronic Liver Disease

Brodersen, Carlos; Koen, E; Ponte, Alicia; Sánchez, Silvina; Segal, Eduardo; Chiapella, Alberto José; Fernández, María Alejandra; Torres, Maria Corina Plaz; Trípodi, Valeria; Lemberg, A

doi:10.1176/appi.neuropsych.12040091

Cited by 11 publications

(8 citation statements)

References 35 publications

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“…Consistent with this hypothesis during the abstinence period, increased levels of LPA have been linked to promoting neuroplasticity and desirable behavioral outcomes related to cognition and emotion [ 15 ]. Interestingly, severe alcoholic and nonalcoholic liver diseases have been linked to a higher risk of cognitive impairment and hepatic encephalopathies through inflammatory responses, cerebrovascular alterations, and insulin resistance, among other mechanisms [ 40 , 41 ]. In this study, the presence of liver diseases abolished all the correlations between the LPA signaling and alcohol-related variables, such as the duration of alcohol abstinence and the dysfunction of the LPA signaling observed through high concentrations of ATX.…”

Section: Discussionmentioning

confidence: 99%

Plasma Concentrations of Lysophosphatidic Acid and Autotaxin in Abstinent Patients with Alcohol Use Disorder and Comorbid Liver Disease

et al. 2021

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Lysophosphatidic acid (LPA) is an endogenous lysophospholipid and a bioactive lipid that is synthesized by the enzyme autotaxin (ATX). The ATX–LPA axis has been associated with cognitive dysfunction and inflammatory diseases, mainly in a range of nonalcoholic liver diseases. Recently, preclinical and clinical evidence has suggested a role of LPA signaling in alcohol use disorder (AUD) and AUD-related cognitive function. However, the ATX–LPA axis has not been sufficiently investigated in alcoholic liver diseases. An exploratory study was conducted in 136 participants, 66 abstinent patients with AUD seeking treatment for alcohol (alcohol group), and 70 healthy control subjects (control group). The alcohol group was divided according to the presence of comorbid liver diseases (i.e., fatty liver/steatosis, alcoholic steatohepatitis, or cirrhosis). All participants were clinically evaluated, and plasma concentrations of total LPA and ATX were measured using enzyme-linked immunosorbent assays. Data were primarily analyzed using analysis of covariance (ANCOVA) while controlling for age, body mass index, and sex. Logistic regression models were created to assess the association of the ATX–LPA axis and AUD or liver disease. LPA and ATX were log10-transformed to fit the assumptions of parametric testing.The main results were as follows: total LPA and ATX concentrations were dysregulated in the alcohol group, and patients with AUD had significantly lower LPA (F(1,131) = 10.677, p = 0.001) and higher ATX (F(1,131) = 8.327, p = 0.005) concentrations than control subjects; patients with AUD and liver disease had significantly higher ATX concentrations (post hoc test, p < 0.05) than patients with AUD but not liver disease; significant correlations between AUD-related variables and concentrations of LPA and ATX were only found in the non-liver disease subgroup (the duration of alcohol abstinence with LPA and ATX (r = +0.33, p < 0.05); and the severity of AUD with ATX (rho = −0.33, p < 0.05)); and a logistic regression model with LPA, ATX, and AUD-related variables showed an excellent discriminative power (area under the curve (AUC) = 0.915, p < 0.001) for distinguishing patients with AUD and comorbid liver disease. In conclusion, our data show that the ATX–LPA axis is dysregulated in AUD and suggest this lipid signaling, in combination with relevant AUD-related variables, as a reliable biomarker of alcoholic liver diseases.

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Section: Discussionmentioning

confidence: 99%

Plasma Concentrations of Lysophosphatidic Acid and Autotaxin in Abstinent Patients with Alcohol Use Disorder and Comorbid Liver Disease

et al. 2021

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“…The global number of individuals living with dementia is 50 million [ 11 ], with the prevalence of cognitive impairment and dementia rising and estimated to increase amongst older adults (60 years and above) to approximately 2 billion by 2050, accounting for 22% of the world’s population [ 12 ]. Cognitive function encompasses multiple mental abilities and skills in reasoning, perception, memory, verbal and mathematical ability and problem solving [ 10 , 13 , 14 ]. Cognitive impairments have been associated with reduced ability to perform complex tasks such as driving and work-related activities leading to impaired quality of life and in more serious cases, premature mortality [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Is there an association between non-alcoholic fatty liver disease and cognitive function? A systematic review

et al. 2022

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Background Non-alcoholic fatty liver disease (NAFLD) is represented as the most common liver disease worldwide. NAFLD is associated with metabolic risk factors underpinned by insulin resistance, inflammation and endothelial dysfunction, leading to extrahepatic changes in central nervous diseases such as cognitive impairment, Alzheimer’s disease and dementia. The aim of the review is to explore the association between NAFLD and cognitive function. Methods Using the PRISMA guidelines, a systematic electronic literature search was conducted in four databases: MEDLINE, PsychINFO, Embase and CINAHL from inception until March 2021. Neuropsychological tests utilised within each study were grouped into relevant cognitive domains including ‘general cognition’, ‘reasoning’, ‘mental speed, attention and psychomotor speed’, ‘memory and learning’, ‘language’, ‘visuospatial perception’ and ‘ideas, abstraction, figural creations and mental flexibility’. Results Eleven observational studies that involved 7978 participants with a mean age of 51 years were included. Those with NAFLD had poor cognitive performance in three cognitive domains, including ‘general cognition’, ‘mental speed, attention and psychomotor speed’, and ‘ideas, abstraction, figural creations and mental flexibility’. Conclusion The observed results from the 11 included studies showed that NAFLD was associated with lower cognitive performance across several domains. However, studies conducted to date are limited to observational designs and are heterogeneous with varying diagnostic tools used to assess cognitive function. Trial registration PROSPERO Registration: CRD42020161640.

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“…Psychiatric illness is highly prevalent in individuals with SUD (Gould, 2010;Kelly & Daley, 2013) and can increase severity of health issues and complicate recovery (Daley & Moss, 2002;Grella, Hser, Joshi, & Rounds-Bryant, 2001). Other common comorbidities that can impact cognition include physical illness, such as vascular conditions (Volkow, Baler, Compton, & Weiss, 2014), respiratory problems (Owen, Sutter & Albertson, 2014), and liver damage (Brodersen et al, 2014). Between 37% and 66% of individuals with an acquired brain injury (ABI, e.g., due to falls, head trauma, overdose, or chronic substance use; Ridley et al, 2018) misuse alcohol, and 10%-44% use illicit substances (Parry-Jones, Vaughan, & Miles Cox, 2006), suggesting potential cumulative cognitive dysfunction.…”

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confidence: 99%

Screening Tools for Cognitive Impairment in Adults with Substance Use Disorders: A Systematic Review

Ridley

Bryce

et al. 2021

J Int Neuropsychol Soc

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Objectives: Cognitive impairment is common in individuals with substance use disorders (SUDs), yet no evidence-based guidelines exist regarding the most appropriate screening measure for use in this population. This systematic review aimed to (1) describe different cognitive screening measures used in adults with SUDs, (2) identify substance use populations and contexts these tools are utilised in, (3) review diagnostic accuracy of these screening measures versus an accepted objective reference standard, and (4) evaluate methodology of included studies for risk of bias. Methods: Online databases (PsycINFO, MEDLINE, Embase, and CINAHL) were searched for relevant studies according to pre-determined criteria, and risk of bias and applicability was assessed using the Quality Assessment of Diagnostic Accuracy Studies–2 (QUADAS–2). At each review phase, dual screening, extraction, and quality ratings were performed. Results: Fourteen studies met inclusion, identifying 10 unique cognitive screening tools. The Montreal Cognitive Assessment (MoCA) was the most common, and two novel screening tools (Brief Evaluation of Alcohol-Related Neuropsychological Impairments [BEARNI] and Brief Executive Function Assessment Tool [BEAT]) were specifically developed for use within SUD populations. Twelve studies reported on classification accuracy and relevant psychometric parameters (e.g., sensitivity and specificity). While several tools yielded acceptable to outstanding classification accuracy, there was poor adherence to the Standards for Reporting Diagnostic Accuracy Studies (STARD) across all studies, with high or unclear risk of methodological bias. Conclusions: While some screening tools exhibit promise for use within SUD populations, further evaluation with stronger methodological design and reporting is required. Clinical recommendations and future directions for research are discussed.

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Cognitive Function in Patients With Alcoholic and Nonalcoholic Chronic Liver Disease

Cited by 11 publications

References 35 publications

Plasma Concentrations of Lysophosphatidic Acid and Autotaxin in Abstinent Patients with Alcohol Use Disorder and Comorbid Liver Disease

Plasma Concentrations of Lysophosphatidic Acid and Autotaxin in Abstinent Patients with Alcohol Use Disorder and Comorbid Liver Disease

Is there an association between non-alcoholic fatty liver disease and cognitive function? A systematic review

Screening Tools for Cognitive Impairment in Adults with Substance Use Disorders: A Systematic Review

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