Comparisons of Korsakoff and Non‐Korsakoff Alcoholics on Neuropsychological Tests of Prefrontal Brain Functioning

Oscar‐Berman, Marlene; Kirkley, Shalene M.; Gansler, David A.; Couture, Ashley

doi:10.1097/01.alc.0000122761.09179.b9

Cited by 124 publications

(133 citation statements)

References 36 publications

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“…Cross-sectional studies have shown that alcoholics sober for several months (Sullivan et al, 2000d;Sullivan et al, 2002;Meyerhoff, 2005;Rosenbloom et al, 2005), one year (Hochla et al, 1982;Parsons et al, 1990;Munro et al, 2000;Rosenbloom et al, 2004), or as long as seven years (Brandt et al, 1983) may still show memory deficits relative to non-alcoholic controls. However, other crosssectional studies have shown that performance on memory tests is related to length of abstinence (Joyce and Robbins, 1993;Oscar-Berman et al, 2004), and that alcoholics sober for more than 4 years are undistinguishable from controls on memory testing (Grant et al, 1984;Reed et al, 1992;Oscar-Berman et al, 2004;Fein et al, 2006). Furthermore, a longitudinal study showed memory improvement relative to baseline after 4 years of abstinence (Rosenbloom et al, 2004).…”

Section: Introductionmentioning

confidence: 98%

Improvement in memory and static balance with abstinence in alcoholic men and women: Selective relations with change in brain structure

Rosenbloom

Rohlfing

O'Reilly

et al. 2007

Psychiatry Research: Neuroimaging

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We investigated whether changes in memory or static balance in chronic alcoholics, occurring with abstinence or relapse, are associated with changes in lateral and fourth ventricular volume. Alcoholics meeting DSM-IV criteria for Alcohol Dependence (n = 15) and non-alcoholic controls (n = 26) were examined twice at a mean interval of two years with standard Wechsler Abbreviated Scale of Intelligence (WASI), Wechsler Memory Scale-Revised (WMS-R) tests, an ataxia battery, and structural MRI. At study entry, alcoholics had been abstinent on average for over 4 months and achieved lower scores than controls on WASI General IQ Index, WMS-R General Memory Index, and the ataxia battery. The ten alcoholics who maintained sobriety at retest did not differ at study entry in socio-demographic measures, alcohol use, or WASI and WMS-R summary scores from the five relapsers. At follow-up, abstainers improved more than controls on the WMS-R General Memory Index. Ataxia tended to improve in abstainers relative to controls. Associations were observed between memory and lateral ventricular volume change and between ataxia and fourth ventricular volume change in alcoholics but not in the controls. Both memory and ataxia can improve with sustained sobriety, and brain-behavior associations suggest selective brain structural substrates for the changes observed.

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Section: Introductionmentioning

confidence: 98%

Improvement in memory and static balance with abstinence in alcoholic men and women: Selective relations with change in brain structure

Rosenbloom

Rohlfing

O'Reilly

et al. 2007

Psychiatry Research: Neuroimaging

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“…Though our inclusion criteria included no history of an acute onset of symptoms associated with Wernicke's encephalopathy (i.e., global confusional state, ocular abnormalities), there is a body of literature suggesting a gradual progression of neurocognitive symptoms or a substantial time period of subclinical symptoms in patients with Wernicke-Korsakoff syndrome [19,[35][36][37] . Despite the distinctions in terminology between Wernicke-Korsakoff and non-Korsakoff alcoholics within the neuropsychology literature [3,20,22] , Bowden [35] indicates that many neuropathologists do not make this differentiation due to the widespread neuropathological changes in alcoholics regardless of a clinical diagnosis of Wernicke-Korsakoff syndrome. For example, postmortem studies report a high incidence of Wernicke-Korsakoff pathology in alcoholics without any antemortem clinical presentation of the syndrome [38] .…”

Section: Discussionmentioning

confidence: 99%

“…The broad range of neuropathology and neuropsychological defi cits may be due, at least in part, to differing nosology and the highly variable inclusion/exclusion criteria in studies. Examples of the existing terminology in the literature include: intact alcoholics [19] , non-Korsakoff alcoholics [20] , patients with alcohol-induced persisting dementia [7] , ARD patients [6] , and patients diagnosed with Wernicke-Korsakoff syndrome [20][21][22] . Variations in methodological criteria include: the age of participants, amount of alcohol consumed, length of alcohol abuse, presence or absence of Wernicke's triad of symptoms (ocular abnormalities, ataxia, and a global confusional state), degree of amnesia, and overall intelligence level.…”

Section: Introductionmentioning

confidence: 99%

The Neuropsychological Profile of Alcohol-Related Dementia Suggests Cortical and Subcortical Pathology

Schmidt

Gallo

Ferri

et al. 2005

Dement Geriatr Cogn Disord

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The neuropathology associated with chronic alcohol abuse varies across studies, though research suggests generalized reductions in cortical and subcortical grey and white matter. Neuropsychological findings also differ within the literature. The inconsistent findings with respect to the neuropathology and neurobehavior of patients with histories of alcohol abuse may be due, at least in part, to differing nosology and the highly variable inclusion/exclusion criteria employed by researchers. Oslin et al. [Int J Geriatr Psychiatry 1998;13:203–212] have proposed and recently validated specific criteria for probable alcohol-related dementia (ARD). We were interested in comparing the neuropsychological profile of ARD patients with the neurocognitive profiles of typical cortical and subcortical dementia patients. Participants included 14 ARD patients, 15 patients diagnosed with Alzheimer’s disease (AD), 13 patients diagnosed with subcortical vascular dementia (VaD), and 20 normal controls. Patient subgroups were similar with respect to age (mean = 79), education (mean = 12 years) and dementia severity (MMSE; mean = 22.1). The three dementia patient subgroups demonstrated significantly worse performance than the normal controls subgroup on all neuropsychological tests. The ARD subgroup exhibited very similar executive control deficits to VaD patients. However, the different neurocognitive profiles of the patient subgroups suggest that ARD patients may also, in fact, demonstrate some degree of amnesia given that they perform slightly worse than subcortical patients on delayed verbal free recall and recognition. Nonetheless, the ARD patients did not display as severe impairment as the AD patients on the memory tasks. No significant differences between the three patient groups were identified on language tests. In sum, we present preliminary evidence of a distinct neuropsychological profile for ARD patients that includes impairment on both executive control and memory tests. This pattern of performance suggests that long-term alcohol abuse, in comparison to AD and VaD, may be associated with both cortical and subcortical neuropathology.

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“…As a result, just like many elderly persons, alcoholics have difficulty with memory, fluency, cognitive flexibility, and perseveration (cf. Dirksen et al 2006;Oscar-Berman et al 2004).…”

Section: Impulses and Compulsionsmentioning

confidence: 99%

Addiction, Chronic Illness, and Responsibility

Hardcastle

2017

Ideas Valores

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Some theorists have argued that we should understand the notion of free will from a functional perspective: free will just is our ability to choose effectively and adaptively in an ever-changing environment. Although far from what many philosophers normally mean by free will, those who adopt this biological-evolutionary perspective can clearly define and defend a notion of personal responsibility. One consequenceof this point of view is that addicts become responsible for their actions, for at each choice point, there is a real sense in which the addict could have elected not to use or abuse. As a result, it has been argued that addiction is not a disease, that addictive behavior is voluntary, and that sometimes it is even rational. This paper defends a different way of thinking about addiction, one that aligns it with other complex chronic illnesses. The perspective put forth here suggests that these discussions about responsibility and free will represent an over-simplified and neuropsychologically inaccurate portrait of basic human capacities for behavioral choice.

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Comparisons of Korsakoff and Non‐Korsakoff Alcoholics on Neuropsychological Tests of Prefrontal Brain Functioning

Abstract: Abnormalities of frontal system functioning are most apparent in alcoholics with Korsakoff's syndrome. In non-Korsakoff alcoholics, factors contributing to cognitive performance are age, duration of abstinence, duration of alcoholism, and amount of alcohol consumed.

Cited by 124 publications

References 36 publications

Improvement in memory and static balance with abstinence in alcoholic men and women: Selective relations with change in brain structure

Improvement in memory and static balance with abstinence in alcoholic men and women: Selective relations with change in brain structure

The Neuropsychological Profile of Alcohol-Related Dementia Suggests Cortical and Subcortical Pathology

Addiction, Chronic Illness, and Responsibility

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