Frontal dysfunction in neurologically normal chronic alcoholic subjects:
 
metabolic and neuropsychological findings

Dao-Castellana, M H; Samson, Yves; Legault, Francine; Martinot, Jean‐Luc; Aubin, Henri‐Jean; Crouzel, C.; Feldman, Lauren; Barrucand, D; Rancurel, G; Féline, A.; Syrota, A.

doi:10.1017/s0033291798006849

Cited by 188 publications

(147 citation statements)

References 28 publications

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“…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.…”

Section: Introductionmentioning

confidence: 94%

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

Chanraud

Martelli

Delain

et al. 2006

Neuropsychopharmacol

368

302

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The extent of structural brain damage and related cognitive deficits has been little described in alcohol-dependent individuals with preserved social functioning. Thus, we investigated the relationship between regional alterations, executive performance, and drinking history. Volumes of gray and white matter were assessed using magnetic resonance imaging voxel-based morphometry in healthy men and in detoxified alcohol-dependent men with good psychosocial functioning. Their executive performance was assessed using neuropsychological tests. Regression analyses were carried out in the regions in which volume differences were detected. Decreases in gray matter were detected bilaterally in alcohol-dependents in the dorsolateral frontal cortex (up to 20% lower), and to a lesser extent in the temporal cortex, insula, thalamus, and cerebellum. Decreases in white matter volume were widespread, being up to 10% in corpus callosum. The degradation of neuropsychological performance correlated with gray matter volume decreases in the frontal lobe, insula, hippocampus, thalami and cerebellum, and with white matter decrease in the brainstem. An early age at first drinking was associated with decreased gray matter volumes in the cerebellum, brainstem (pons), and frontal regions. Regional alteration in gray and white matter volume was associated with impairment of executive function despite preserved social and somatic functioning in detoxified patients. Besides involving frontal regions, these findings are consistent with a cerebello-thalamo-cortical model of impaired executive functions in alcohol-dependent individuals.

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Section: Introductionmentioning

confidence: 94%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Chanraud

Martelli

Delain

et al. 2006

Neuropsychopharmacol

368

302

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“…4 An alcoholic-selective frontal dysfunction is also supported by functional imaging studies, where glucose hypometabolism has been reported in the mediofrontal cortex. 5,6 Furthermore, neuronal loss and a reduction in basal dendritic arborisation were described in the superior frontal cortex of alcoholics. 1 Together, these pathological findings may help explain the functional changes and cognitive deficits, which are frequently observed in alcoholic patients.…”

Section: Introductionmentioning

confidence: 99%

Differential protein expression in the prefrontal white matter of human alcoholics: a proteomics study

et al. 2005

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Neuroimaging and post-mortem studies indicate that chronic alcohol use induces global changes in brain morphology, such as cortical and subcortical atrophy. Recent studies have shown that frontal lobe structures are specifically susceptible to alcohol-related brain damage and shrinkage in this area is largely due to a loss of white matter. This may explain the high incidence of cognitive dysfunction observed in alcoholics. Using a proteomics-based approach, changes in protein expression in the dorsolateral prefrontal region (BA9) white matter were identified in human alcoholic brains. Protein extracts from the BA9 white matter of 25 human brains (10 controls; eight uncomplicated alcoholics; six alcoholics complicated with hepatic cirrhosis; one reformed alcoholic) were separated using two-dimensional gel electrophoresis. Overall, changes in the relative expression of 60 proteins were identified (Po0.05, ANOVA) in the alcoholic BA9 white matter. In total, 18 protein spots have been identified using MALDI-TOF; including hNP22, a-internexin, transketolase, creatine kinase chain B, ubiquitin carboxy-terminal hydrolase L1 and glyceraldehyde-3-phosphate dehydrogenase. Several of these proteins have been previously implicated in alcohol-related disorders and brain damage. By identifying changes in protein expression in this region from alcoholics, hypotheses may draw upon more mechanistic explanations as to how chronic ethanol consumption causes white matter damage.

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“…Chronic alcohol use causes atrophy of the frontal lobes 11,12 and hypometabolism in the frontal cortex. [13][14][15] It leads to a pattern of impaired executive functioning related to frontal lobe dysfunction and impaired memory that is detectable by neuropsychological testing. 14,16,17 Alcohol use may have direct neurotoxic effects leading to the syndrome of alcohol-related dementia.…”

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confidence: 99%

“…[13][14][15] It leads to a pattern of impaired executive functioning related to frontal lobe dysfunction and impaired memory that is detectable by neuropsychological testing. 14,16,17 Alcohol use may have direct neurotoxic effects leading to the syndrome of alcohol-related dementia. 18,19 Whether surgery during general anesthesia may produce greater degrees of cognitive dysfunction in patients with a history of alcohol abuse has not been explored.…”

mentioning

confidence: 99%

Postoperative Cognitive Dysfunction in Older Patients with a History of Alcohol Abuse

Hudetz

Iqbal²,

Gandhi

et al. 2007

Anesthesiology

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Background: Postoperative cognitive dysfunction (POCD) affects a significant number of patients and may have serious consequences for quality of life. Although POCD is most frequent after cardiac surgery, the prevalence of POCD after noncardiac surgery in older patients is also significant. The risk factors for POCD after noncardiac surgery include advanced age and preexisting cognitive impairment. Self-reported alcohol abuse is a risk factor for postoperative delirium, but its significance for long-term POCD has not been investigated. The goal of this study was to determine whether neurocognitive function is impaired after noncardiac surgery during general anesthesia in older patients with a history of alcohol abuse.Methods: Subjects aged 55 yr and older with self-reported alcohol abuse (n ‫؍‬ 28) and age-, sex-, education-matched nonalcoholic controls (n ‫؍‬ 28) were tested using a neurocognitive battery before and 2 weeks after elective surgery (n ‫؍‬ 28) or a corresponding time interval without surgery (n ‫؍‬ 28). Verbal memory, visuospatial memory, and executive functions were assessed. A neurologic examination was performed to exclude subjects with potential cerebrovascular damage.Results: Significant three-way interactions (analysis of variance) for Visual Immediate Recall, Visual Delayed Recall, Semantic Fluency, Phonemic Fluency, and the Color-Word Stroop Test implied that cognitive performance in the alcoholic group decreased after surgery more than it did in the other three groups.Conclusions: The results suggest that a history of alcohol abuse in older patients presents a risk for postoperative cognitive impairment in the domains of visuospatial abilities and executive functions that may have important implications for quality of life and health risks.

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Frontal dysfunction in neurologically normal chronic alcoholic subjects: metabolic and neuropsychological findings

Abstract: These data indicate that circumscribed frontal dysfunctions may occur in chronic alcoholic subjects before clinically obvious neurological complications, and may account for some of the alcohol-related neuropsychological and behavioural impairments.

Cited by 188 publications

References 28 publications

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

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

Differential protein expression in the prefrontal white matter of human alcoholics: a proteomics study

Postoperative Cognitive Dysfunction in Older Patients with a History of Alcohol Abuse

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