Validation of a Brief Screening Tool for Alcohol‐Related Neuropsychological Impairments

Ritz, Ludivine; Lannuzel, Coralie; Boudehent, Céline; Vabret, François; Bordas, N.; Segobin, Shailendra; Eustache, Francis; Pitel, Anne‐Lise; Beaunieux, Hélène

doi:10.1111/acer.12888

Cited by 39 publications

(42 citation statements)

References 46 publications

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“…Finally, two CSIs have recently been developed specifically for assessing alcohol-related cognitive impairments, the Brief Examination of Alcohol-Related Neuropsychological Impairments (BEARNI; Ritz et al, 2015) and the Test of Detection of Cognitive Impairment in Alcoholism (TEDCA; Jurado-Barba et al, 2017), though both have only been validated in AL populations not meeting ARCI diagnostic criteria (both CSIs can be accessed in the corresponding publications [the BEARNI is in French]). The BEARNI was designed as an easily administered CSI for assessing the deficits associated with alcoholism: working and episodic memory, visuospatial abilities, EF, and ataxia.…”

Section: Discussionmentioning

confidence: 99%

“…The BEARNI was designed as an easily administered CSI for assessing the deficits associated with alcoholism: working and episodic memory, visuospatial abilities, EF, and ataxia. In its validation, Ritz et al (2015) found the BEARNI was considerably more sensitive when differentiating between ALs and controls (sensitivity = 98.4%) compared with the MMSE (9.5%) and Dementia Rating Scale (7.9%; Coblentz et al, 1973). However, the tool displayed relatively poor specificity (50%).…”

Section: Discussionmentioning

confidence: 99%

“…Third, we did not include studies evaluating neuropsychological tools in AL participants, which could have provided additional information on the utility of tests for the assessment of alcohol-related deficits. However, we have introduced some of the more pertinent and up-to-date evidence relating to ALs (e.g., Alarcon et al, 2015; Ritz et al, 2015) into our discussion to supplement the review findings. Fourth, several studies in the review evaluated older versions of tests used today (e.g., WMS/WAIS editions), thus caution should be taken in applying these findings to newer versions.…”

Section: Discussionmentioning

confidence: 99%

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Identification and Evaluation of Neuropsychological Tools Used in the Assessment of Alcohol-Related Cognitive Impairment: A Systematic Review

2018

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Background: Neuropsychological assessment is central to identifying and determining the extent of Alcohol-Related Cognitive Impairment (ARCI). The present systematic review aimed to synthesize and discuss the evidence appraising the neuropsychological tests used to assess ARCI in order to support clinicians and researchers in selecting appropriate tests for use with this population.Methods: We searched for studies investigating the psychometric, diagnostic and practical values of tools used in the screening, diagnosis, and assessment of Korsakoff's Syndrome (KS), Alcohol-Related Dementia (ARD), and those with a specific diagnosis of Alcohol-Related Brain Damage (ARBD). The following databases were searched in March 2016 and again in August 2018: MEDLINE, EMBASE, Psych-INFO, ProQuest Psychology, and Science Direct. Study quality was assessed using a checklist designed by the authors to evaluate the specific factors contributing to robust and clearly reported studies in this area. A total of 43 studies were included following the screening of 3646 studies by title and abstract and 360 at full-text. Meta-analysis was not appropriate due to heterogeneity in the tests and ARCI samples investigated in the studies reviewed. Instead, review findings were narratively synthesized and divided according to five domains of assessment: cognitive screening, memory, executive function, intelligence and test batteries, and premorbid ability. Effect sizes (d) were calculated to supplement findings.Results: Overall, several measures demonstrated sensitivity to the cognitive deficits associated with chronic alcoholism and an ability to differentiate between gradations of impairment. However, findings relating to the other psychometric qualities of the tests, including those important for the accurate assessment and monitoring of ARCI (e.g., test-retest reliability), were entirely absent or limited. Additionally, the synthesis of neuropsychological outcomes presented here supports the recent impetus for a move away from discrete diagnoses (e.g., KS, ARD) and the distinctions between them toward more broad and inclusive diagnostic conceptualizations of ARCI, thereby recognizing the heterogeneity in presentation.Conclusions: Based on the evidence reviewed, provisional recommendations for appropriate tests in each domain of assessment are presented, though further validation of most tests is warranted. Review findings can support efficient and evidenced-based test-selection and guide future research in this area.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Identification and Evaluation of Neuropsychological Tools Used in the Assessment of Alcohol-Related Cognitive Impairment: A Systematic Review

2018

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“…These thresholds led to the establishment of operational criteria that can now be used in a clinical setting. If these findings are associated with a screening tool for alcohol-related neuropsychological impairments, such as the BEARNI [ 50 ], clinicians will be able to identify patients at risk of severe impairment and needing preventive action and specific care, including nutritional and hepatic treatment.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Biological Risk Factors for Neuropsychological Impairment in Alcohol Use Disorder

et al. 2016

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The effects of alcoholism on cognitive and motor functioning are heterogeneous. While the role of some factors (patterns of alcohol consumption, eating habits or associated liver disease) has been hypothesized, the origins of this heterogeneity remain difficult to establish. The goals of the present study were thus to identify the clinical and biological risk factors for alcohol-related neuropsychological impairments and to determine the threshold beyond which these risk factors can be considered significant. Thirty alcoholic patients and 15 healthy controls had a blood test and underwent a neuropsychological examination. Alcohol severity measures, and liver, thiamine and malnutrition variables, were included in logistic regression models to determine the risk factors for cognitive and motor impairments (executive functions, visuospatial abilities, verbal episodic memory, ataxia), as well as those related to the severity of patients’ overall neuropsychological profile (moderate or severe impairments). Liver fibrosis was found to be a risk factor for executive impairments and also for ataxia, when it was associated with long-term alcohol misuse and symptoms of withdrawal. Altered thiamine metabolism was solely predictive of verbal episodic memory impairments. This combination of biological abnormalities was associated with a profile of moderate neuropsychological impairments. Malnutrition was associated with a profile of more severe impairments. Malnutrition, altered liver function and thiamine metabolism explain, at least partially, the heterogeneity of alcohol-related neuropsychological impairments. Our findings could allow clinicians to identify patients at particular risk of severe neuropsychological impairments before the onset of irreversible and debilitating neurological complications.

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“…They are lengthy to administer and often complicated; for example, in the study performed by Davies et al, administration lasted from 60 to 90 min [20], whilst Glass et al [21] used 6 different tests. A new test, the Bearni, has been recently proposed [22] but was not available at the time we began our investigation.…”

Section: Introductionmentioning

confidence: 99%

Investigation of Cognitive Improvement in Alcohol-Dependent Inpatients Using the Montreal Cognitive Assessment (MoCA) Score

Pelletier¹,

Nalpas

Alarcon³

et al. 2016

Journal of Addiction

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Background. Cognitive dysfunction is a common feature in alcohol use disorders. Its persistence following alcohol detoxification may impair quality of life and increase the risk of relapse. We analyzed cognitive impairment changes using the Montreal Cognitive Assessment (MoCA) score in a large sample of alcohol-dependent inpatients hospitalized for at least 4 weeks. Method. This was an observational longitudinal survey. Inclusion criteria were alcohol dependence (DSM-IV) and alcohol abstinence for at least one week. The MoCA test was administered on admission and at discharge. Results. 236 patients were included. The mean MoCA score significantly increased from 22.1 ± 3.7 on admission to 25.11 ± 3.12 at discharge. The corresponding effect-size of improvement was high, 1.1 [95% CI 1.0–1.2]. The degree of improvement was inversely correlated with the baseline MoCA score. The rate of high and normal, that is, >26, MoCA values increased from 15.8% on admission to 53.8% at discharge. MoCA score improvement was not correlated with the total length of abstinence prior to admission. Conclusion. The MoCA score seems to be a useful tool for measuring changes in cognitive performance in alcohol-dependent patients. A significant improvement in cognitive function was observed whatever the degree of impairment on admission and even after a long abstinence period.

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Validation of a Brief Screening Tool for Alcohol‐Related Neuropsychological Impairments

Abstract: This study indicates that the BEARNI is a useful screening tool in clinical settings for detecting ALs' motor and cognitive impairments.

Cited by 39 publications

References 46 publications

Identification and Evaluation of Neuropsychological Tools Used in the Assessment of Alcohol-Related Cognitive Impairment: A Systematic Review

Identification and Evaluation of Neuropsychological Tools Used in the Assessment of Alcohol-Related Cognitive Impairment: A Systematic Review

Clinical and Biological Risk Factors for Neuropsychological Impairment in Alcohol Use Disorder

Investigation of Cognitive Improvement in Alcohol-Dependent Inpatients Using the Montreal Cognitive Assessment (MoCA) Score

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