Early Improvement of Neuropsychological Impairments During Detoxification in Patients with Alcohol Use Disorder
Journal article
Overview
Many people live with an alcohol use disorder. This can lead to a plethora of problems with cognitive functioning, including lack of attention, impairments in executive functioning, memory loss, and more. Deficits in cognition have been linked to higher rates of relapse and more severe substance use disorder symptoms.
But scientific research is suggesting that some forms cognitive functioning can improve when people with alcohol use disorder or addiction quit alcohol use. But so far the factors affecting these improvements have not been well understood. This new study takes a longitudinal approach to studying cognitive improvements.
For their study, Bernard Angerville and colleagues utilized 32 participants who had severe alcohol use disorder and 32 healthy people in a control group to serve as their sample. The alcohol use disorder (AUD) group consisted of people who were admitted to a substance use program in a French psychiatric hospital between April 2018 and January 2019. Exclusion criteria for the alcohol use group was use of other substances, other psychiatric diagnoses, use of psychotropic medication, and history of health issues, such as stroke, head trauma, epilepsy, and liver fibrosis.
The AUD patients participated in a detoxification program that included treatment workshops and oral thiamine. Treatment lasted five to nine days. The healthy controls were pulled from an online database and had no history of mental illness, neurological disorders, or serious diseases. All participants completed measures on sociodemographic information, substance use, and BEARNI neuropsychological assessments.
Neuropsychological assessments tested verbal episodic memory, verbal working memory, executive functioning, and visuospatial abilities. Participants who had alcohol use disorder were tested at eight days and 18 days after quitting alcohol use.
Results showed that nearly 60% of patients with alcohol use disorder showed cognitive impairments 8 days after cessation of alcohol. Among those who showed impairments, 63% showed improvement in their deficits such that they reached normal levels of functioning after 18 days of discontinuing alcohol usage.
- Promising recovery rates were shown for working memory and episodic memory at 60% and 63% respectively.
- 67% of participants who showed visuospatial impairments at the first data collection point displayed normal levels at the second data collection point.
- Additionally, the recovery of flexibility performance was 100%.
The study thus shows that in just 18 days, improvement in cognitive functions after having stopped consuming alcohol are possible.
This is the fastest improvement ever seen in people with AUD in one study. It is also possible that the cognitive deficits begin to decrease in an even shorter period of time. However, more studies are needed to know for sure, according to reporting by Cyril Renault for Sain et Naturel Ouest France.
Caregivers should take into account the neuropsychological impairments before 18 days of abstinence, considering that cognitive impairments are linked to the treatment addiction outcomes,” the researchers said, according to PsyPost reporting.
Eighteen days after alcohol cessation could represent a critical timepoint to begin psychotherapies, such as cognitive behavioral therapy, which requires intact cognitive functioning to be effective.”
Bernard Angerville, Ludivine Ritz, Anne-Lise Pitel, Hélène Beaunieux, Hakim Houchi, Margaret P Martinetti, Mickaël Naassila, Alain Dervaux, Early Improvement of Neuropsychological Impairments During Detoxification in Patients with Alcohol Use Disorder, Alcohol and Alcoholism, Volume 58, Issue 1, January 2023, Pages 46–53, https://doi.org/10.1093/alcalc/agac048
This study took important steps into better understanding how cognition can be improved following detox from severe alcohol use disorder.
There are limitations to acknowledge, for example that the sample size was small. This was in part due to the stringent exclusion criteria, which kept the sample homogenous. Additionally, tobacco and nicotine use were not included in the exclusion criteria, which could have an effect on cognition.
Additional studies assessing cognitive improvements during abstinence, and especially earlier in abstinence, are needed,” the researchers concluded, as per to PsyPost reporting.
Further studies should also assess the early course of social cognition, attentional bias and inhibition deficits in patient with alcohol use disorder early in abstinence, given their clinical impact.”
Bernard Angerville, Ludivine Ritz, Anne-Lise Pitel, Hélène Beaunieux, Hakim Houchi, Margaret P Martinetti, Mickaël Naassila, Alain Dervaux, Early Improvement of Neuropsychological Impairments During Detoxification in Patients with Alcohol Use Disorder, Alcohol and Alcoholism, Volume 58, Issue 1, January 2023, Pages 46–53, https://doi.org/10.1093/alcalc/agac048
Abstract
Aims
To assess recovery of alcohol-related neuropsychological deficits in a group of patients with pure severe alcohol use disorder (AUD) during a detoxification program using the Brief Evaluation of Alcohol-Related Neuropsychological Impairment (BEARNI) test.
Methods
Thirty-two patients with severe AUD using DSM-IV criteria (24 men, mean age = 45.5 ± 6.8 years old) were assessed using the BEARNI 8 ± 2 days after alcohol cessation (T1) and then were reassessed within 18 ± 2 days after alcohol cessation (T2).
The primary study endpoint was the number of patients initially impaired at T1 who recovered cognitive functions at T2 assessment.
Results
At T1, 59% (n = 19) patients with pure severe AUD had at least one impaired cognitive function assessed by the BEARNI.
At T2, 63% of the patients with AUD with deficits at T1 had normal BEARNI cognitive scores; specifically, the percentages of participants with normal subtest scores were 63% on memory, 100% on verbal fluency, 60% on alphabetical span, and 67% on visuospatial.
Conclusions
The cognitive impairments of two-thirds of patients with pure AUD included in the present study recovered within 18 days of abstinence, earlier than reported in previous studies.
