Alcohol dependent individuals lack executive control and their high level cognitive functioning is damaged, requiring rehabilitation.

adResearchers in the field are well aware that alcohol impacts on brain functioning. A new study confirms the destruction of brain functioning suggesting that there is severe impairment in cognitive skills of alcohol dependent, (AD), individuals. The results of the study will be published in July 2014, in the online issue of Alcoholism, and analyzed the impact on three networks involved in brain functioning: altering, orienting and executive control. Deficits in executive control were severely pronounced.

In this study 30 sober and detoxified alcohol dependent individuals were recruited as well as 30 individuals who drank lightly. The subjects were matched for age, gender and education. The research participants completed the Attention Network Test designed to examine changes related to the three intentional network described above. The alcohol dependent individuals had substantial difficulties resolving task conflicts and the deficits were found at the higher level of attentional network called executive control, specifically, executive functions and frontal lobe functioning. The deficits were related to the direct effects of the duration and intensity of AD on the frontal regions of the brain.

“Excessive drinking has a negative impact on brain structure and functioning, leading to neuronal loss and impaired functioning of several , particularly the frontal lobe or the anterior part of the brain, that is the prefrontal and frontal areas,” said Pierre Maurage, a professor at the Université catholique de Louvain as well as corresponding author for the study.

“These areas are notably responsible for higher cognitive functions, like the ability to plan, adapt or inhibit our behaviors according to changes in our environment. AD can impair these high-level cognitive functions, leading to maladapted behaviors, particularly an inability to inhibit behaviors.”

“Attention is of course a fundamental process of human cognition,” said Salvatore Campanella, professor of psychopathology at the University of Brussels, and research associate at the Belgian Fund of Scientific Research. “Moreover, it is true that attention may be subdivided in several sub-components, implemented in partially different neural networks. Therefore, investigating which attentional mechanisms are specifically affected by is highly relevant at the clinical level, as different forms of attentional disabilities may be differently rehabilitated.”

“While earlier studies had described globally impaired attentional abilities in AD on the basis of unspecific tasks,” said Maurage, “we found that attention is not globally impaired in AD. Indeed, two attentional networks — alerting and orienting — present preserved functioning in AD, while deficits were found at the higher level of attentional network called executive control, specifically, executive functions and frontal lobe functioning. Importantly, this deficit seems related to the direct effects of the duration and intensity of AD on the frontal regions of the brain.”

“In summary,” added Campanella, “attentional abilities are not all affected by . The main problem induced by long-term alcohol abuse is an inability to detect and resolve the conflict between task-relevant stimulus and interference provoked by task-irrelevant stimuli: in other words, alcoholics have difficulties in engaging attention on pertinent stimuli, and disengaging attention from non-pertinent stimuli.”

“Practically speaking, this means that the ability to correctly react and to orient one’s attention to stimulations present in the environment, which is a crucial ability for everyday life, is still present in AD, but these attentional abilities are not correctly used because the deficit in executive control hampers the adaptive and efficient use of them,” said Maurage. “At the clinical level, it also shows that therapeutic programs should not focus on the rehabilitation of basic attentional features, because they are actually preserved, but rather on high-level executive functions like or impulsivity control in order to improve attention.”

The researchers recommend that therapeutic programs should be used to rehabilitate specifically impaired abilities, improving executive control and reducing the of relapse.

Source

Pierre Maurage, Philippe de Timary, Joël Billieux, Marie Collignon, Alexandre Heeren. Attentional Alterations in Alcohol Dependence Are Underpinned by Specific Executive Control Deficits. Alcoholism: Clinical and Experimental Research, 2014; DOI: 10.1111/acer.12444

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