Neurocognition and inhibitory control in polysubstance use disorders: Comparison with alcohol use disorders and changes with abstinence

Abstract

Introduction Intact neurocognition and early cognitive recovery during abstinence are important for substance use treatment outcome. Yet, little is known about them in the largest group of treatment seekers today, individuals with polysubstance use disorders (PSU). This study primarily contrasted PSU and individuals with an alcohol use disorder (AUD) on neurocognitive and inhibitory control measures and, secondarily, measured changes during abstinence in PSU. Method At one month of abstinence from all substances except tobacco, 36 PSU and 69 AUD completed neurocognitive assessments of executive function, general intelligence, auditory-verbal learning/memory, visuospatial learning/memory/skills, processing speed, working memory, fine motor skills, and cognitive efficiency. The groups were also assessed on inhibitory control measures of self-reported impulsivity, risk-taking, and decision-making. Seventeen PSU repeated the assessments after approximately four months of abstinence. All cross-sectional and longitudinal analyses included smoking status as a possible confound. Results At baseline, PSU performed significantly worse than AUD on auditory-verbal memory and on an inhibitory control measure of impulsivity. Polysubstance users showed trends to worse performance than AUD on general intelligence, auditory-verbal learning, and a decision-making task. Between one and four months of abstinence, PSU showed significant improvements on several neurocognitive and inhibitory control measures. Conclusions Polysubstance users exhibit distinct differences in neurocognition and inhibitory control compared to AUD. Between one and four months of abstinence, neurocognition and inhibitory control improve in PSU. This neurocognitive recovery in some domains of abstinent PSU is influenced by smoking status. These results underscore the clinical value of select methods to augment neurocognitive recovery in PSU through appropriate interventions.

Parental reflective functioning and executive functioning in mothers with substance use disorder

“…Although there were variations within the group, the mothers exhibited an average PRF score lower than 3, indicating that as a group, the ability to keep a mental model of oneself and the child in mind was poorly integrated, although not completely absent. In addition, in previous studies of SUD populations, including studies of mothers with SUD, deficits in EF are reported (Cuevas, Deater-Deckard, Kim-Spoon, Watson, Morasch et al, 2014;Deater-Deckard, 2014;Koob & Volkow, 2016;Schmidt, Pennington, Cardoos, Durazzo, & Meyerhoff, 2017). These studies support our findings of impairments in cognitive flexibility, inhibition and working memory.…”

Structural neuroimaging in polysubstance users

“…The volume changes in PSU were significant for left caudate (increase) and right superior temporal lobe (decrease). These structural changes may underlie the significant cognitive improvements measured in these PSU individuals during abstinence, including in the clinically relevant domains of executive function, working memory, and cognitive efficiency [47]. The demonstration that the brain recovers after chronic polysubstance use by effectively engaging neuroplasticity suggests a critical window of opportunity for intervention with plasticity-based cognitive remediation methods.…”

Emotional Availability, Neuropsychological Functioning, and Psychopathology: The Context of Parental Substance Use Disorder

“…It is well-known that the executive functions are involved in the control and regulation of emotional and behavioral processes [ 12 ]. Empirical evidence demonstrates that individuals with SUD are more likely to exhibit neuropsychological impairments [ 20 , 42 ], including impairments in general intelligence and various executive functioning tasks [ 43 ], as well as neural abnormalities in frontal lobes, as indicated by imaging studies [ 44 , 45 ]. Furthermore, research indicates that parental EF could be transmitted through generations [ 46 , 47 ].…”