The Rey Auditory Verbal Learning Test: A follow-up study in alcoholics with and without neurological disease

The Rey Auditory Verbal Learning Test (RAVLT) was used to detect abnormalities of memory and learning in 41 heavy drinkers (median daily consumption, 170g). Results were compared with those obtained in 13 age-matched control subjects (median daily alcohol consumption, 30g). Recall of the 15-word list of the RAVLT was significantly decreased in all 5 trials in the heavy drinkers. Those without clinical signs of alcohol-related neurological illness had significantly better scores than those with signs, but performed significantly worse than the control subjects. Patients with Korsakoff's psychosis obtained very low scores on the RAVLT. Those without Korsakoff's psychosis had significantly lower scores than the controls. The patients were re-tested after a mean interval of 10 months during which 23 were abstinent and 18 continued to drink. Scores obtained in the RAVLT did not change significantly in either group.

We conclude that memory and learning may be impaired in heavy drinkers before clinical signs of neurological disease are evident, and that there is a spectrum of memory loss, one extreme of which is Korsakoff's psychosis. Impaired learning and memory do not improve after abstinence for 10 months.     

Omega-3 polyunsaturated fatty acids and cognition in a college-aged population

The cognitive influences of omega-3 polyunsaturated fatty acids (n-3 PUFA) remain unclear throughout the life span. Dietary n-3 PUFA appear cognitively beneficial prenatally and neuroprotective at later age; however, researchers using supplementation designs have reported disparate findings across age groups. Few studies have examined the cognitive impact of n-3 PUFA during young adulthood. This study assessed the cognitive effects of fish oil supplementation at college age, hypothesizing benefits on affect, executive control, inhibition, and verbal learning and memory. College-aged participants were assigned to active (n = 20, 5 men; age = 19.9, sage = 1.8) or placebo (n = 21, 7 men; age = 20.4, sage = 1.6) treatments, receiving fish oil (480 mg DHA/720 mg EPA) or coconut oil, respectively. Both groups completed four weeks of supplementation. At baseline and posttreatment, the researchers administered the Rey Auditory Verbal Learning Test (RAVLT; Lezak, 1995), Stroop Color and Word Test (SCWT; Golden & Freshwater, 2002), Trail Making Test (TMT; Corrigan & Hinkeldey, 1987; Gaudino, Geisler, & Squires, 1995; Lezak, 1995), and Positive and Negative Affect Schedule (PANAS; Watson, Clark, & Tellegen, 1988). Repeated-measures ANOVAs indicated no benefits of fish oil on the SCWT, RAVLT Stages 1 to 5, or PANAS. An interaction occurred between condition and time of measurement (i.e., baseline and posttreatment) on RAVLT Stages 6 and 7, and placebo significantly improved TMT performance over fish oil. The benefits of n-3 PUFA on RAVLT performance derived more from depreciated placebo performance than improved performance due to fish oil. The placebo gain on TMT performance likely derived from a learning effect. Together, these results present limited cognitive benefits of n-3 PUFA at college age; however, the treatment may have been subtherapeutic, with a larger sample needed to generalize these results.     

Identification of the alcoholic schizophrenic: use of clinical laboratory tests and the MAST

A screening procedure to identify alcohol abuse among schizophrenics is sorely needed. We evaluated the utility of a particular screening battery that consisted of three standard clinical laboratory tests (GGTP, MCV, SGOT) and the Michigan Alcoholism Screening Test (MAST). Consecutive admissions to an acute psychiatric unit and to an alcohol rehabilitation program were initially evaluated for inclusion in three diagnostic groupings: alcoholic schizophrenics, nonalcoholic schizophrenics and nonschizophrenic alcoholics. Twenty inpatient veterans were selected for each diagnostic group. These groups were then compared in terms of scores on the GGTP, MCV, SGOT and MAST. The MAST had the greatest sensitivity, but suffered low specificity. The GGTP demonstrated excellent specificity, but very poor sensitivity. When multiple tests were considered, the combination of the MAST and GGTP proved the best at identifying alcohol abuse in schizophrenics. The false positive rate was unacceptably high, however. The test battery was not useful in discriminating between nonalcoholic schizophrenics and alcoholic schizophrenics, yet could distinguish the nonschizophrenic alcoholics from the two schizophrenic groups.     

Alcohol calibration of tests measuring skills related to car driving

Rationale

Medication and illicit drugs can have detrimental side effects which impair driving performance. A drug’s impairing potential should be determined by well-validated, reliable, and sensitive tests and ideally be calibrated by benchmark drugs and doses. To date, no consensus has been reached on the issue of which psychometric tests are best suited for initial screening of a drug’s driving impairment potential.

Objective

The aim of this alcohol calibration study is to determine which performance tests are useful to measure drug-induced impairment. The effects of alcohol are used to compare the psychometric quality between tests and as benchmark to quantify performance changes in each test associated with potentially impairing drug effects.

Methods

Twenty-four healthy volunteers participated in a double-blind, four-way crossover study. Treatments were placebo and three different doses of alcohol leading to blood alcohol concentrations (BACs) of 0.2, 0.5, and 0.8 g/L.

Results

Main effects of alcohol were found in most tests. Compared with placebo, performance in the Divided Attention Test (DAT) was significantly impaired after all alcohol doses and performance in the Psychomotor Vigilance Test (PVT) and the Balance Test was impaired with a BAC of 0.5 and 0.8 g/L. The largest effect sizes were found on postural balance with eyes open and mean reaction time in the divided attention and the psychomotor vigilance test.

Conclusions

The preferable tests for initial screening are the DAT and the PVT, as these tests were most sensitive to the impairing effects of alcohol and being considerably valid in assessing potential driving impairment.     

Medical Students and Drugs: Further Neuropsychological and Use Pattern Considerations

Drug use patterns of 134 freshman medical students were surveyed. Ninety-four percent reported experience with alcohol, 72% with marijuana, 24% with hallucinogens or stimulants, and 7% with opiates. Persons who reported use of the least socially sanctioned substances (hallucinogens, stimulants, opiates) were a subgroup of marijuana users, whereas marijuana experienced students were a subgroup of alcohol users. Increasing marijuana use appears to be associated with increased alcohol consumption. Twenty-five students who had never used marijuana and 26 students who had used it on 50 or more occasions were compared on three neuropsychological tests: Tactual Performance Test, Minnesota Perceptuo-Diagnostic Test, and the Hutt Adaptation of the Bender Gestalt Test. There were no neuropsychological differences between marijuana experienced and marijuana naive subjects. The methodological difficulties in studying the long-term cerebral effects of marijuana are discussed.     

Drinking habits and laboratory tests in seamen with and without chemical exposure.

The purpose of this study was to evaluate possible differences in drinking habits among seamen exposed to organic solvents and other hydrocarbon compounds compared to unexposed seamen. Information about alcohol consumption and alcohol-related problems was obtained by using an abbreviated version of the Michigan Alcoholism Screening Test, as well as additional questions about the quantity of alcohol consumption. Also, tests of serum gamma-glutamyl transferase and mean corpuscular volume were performed to reveal possible chronic toxic effects of chemical exposure and alcohol consumption, as physicians often use these blood tests in their health controls of seamen. The relationships between chemical exposure, age, smoking and alcohol consumption and results from blood tests were analyzed by using multiple regression analyses. Seamen exposed to organic solvents and other hydrocarbon compounds had more alcohol-related problems and more months of heavy drinking than did unexposed seamen. The previous year's alcohol consumption was similar in the two groups. A relationship between alcohol consumption and chemical exposure was not found. No correlation was found between chemical exposure and the results from the blood tests. Routine monitoring of gamma-glutamyl transferase and mean corpuscular volume did not seem useful in the evaluation of chemical hazards.     

Factors triggering abolishment of benzodiazepines effects in the Four-Plate Test--retest in mice.

Abolishment of anxiolytic-like effects of diazepam occurs during re-exposure to some animal tests of anxiety. We investigated the loss of anxiolytic-like effects of diazepam during Trial 2 on previously undrugged mice, namely one-trial tolerance (OTT). Swiss mice were subjected to 1) Four-Plate Test (FPT) without punishments in Trial 1 or 2) FPT without punishments in both Trials or 3) FPT with spatial modifications in Trial 1 or 4) Elevated Plus Maze (EPM), then 24 h later to FPT, with saline, diazepam (1 mg/kg) or DOI (1 mg/kg). Removing punishments in Trial 1 does not counteract the effect reduction of diazepam in Trial 2, but spatial modifications of the aversive environment. Previous exposure to EPM does not trigger a loss of efficacy of diazepam in FPT. Electric punishments do not trigger OTT to benzodiazepines; whilst knowledge of the environment seems to be responsible for this phenomenon. FPT may be useful to study OTT because punishments potentate OTT in this model of anxiety.     

Diagnostic practices of evaluators of drunken drivers

This study was designed to evaluate the impact of driving under the influence (DUI) arrest history on the diagnostic decisions of DUI evaluators and the reported bases on which alcohol-related diagnostic decisions are made in DUI cases. Subjects were 70 (out of a potential 140) Illinois certified DUI evaluators who responded by mail to one of four case summaries containing different information about a "client's" drinking history and arrest history. Results indicated a significant difference in the frequency with which these DUI evaluators noted whether the "client" had an alcohol problem, with zero, one and two DUI arrests yielding approximately 30%, 15%, and 50% alcohol diagnoses in the absence of DSM-III criteria supporting such a diagnosis. Collaborative reports by significant others and alcohol-related tests (e.g., Michigan Alcoholism Screening Test) were the two most frequently reported bases. The costs of such diagnostic unreliability and the disadvantages of collaborative reports and screening tests are discussed.     

Effects of alcohol on tests of executive functioning in men and women: a dose response examination

Alcohol has been shown to affect performance on tasks associated with executive functioning. However, studies in this area have generally been limited to a single dose or gender or have used small sample sizes. The purpose of this study was to provide a more nuanced and systematic examination of alcohol's effects on commonly used tests of executive functioning at multiple dosages in both men and women. Research volunteers (91 women and 94 men) were randomly assigned to one of four drink conditions (alcohol doses associated with target blood alcohol concentrations of .000%, .050%, .075%, and .100%). Participants then completed three tasks comprising two domains of executive functioning: two set shifting tasks, the Trail Making Test and a computerized version of the Wisconsin Card Sorting Task, and a response inhibition task, the GoStop Impulsivity Paradigm. Impaired performance on set shifting tasks was found at the .100% and .075% dosages, but alcohol intoxication did not impair performance on the GoStop. No gender effects emerged. Thus, alcohol negatively affects set shifting at moderately high levels of intoxication in both men and women, likely attributable to alcohol's interference with prefrontal cortex function. Although it is well established that alcohol negatively affects response inhibition as measured by auditory stop-signal tasks, alcohol does not appear to exert a negative effect on response inhibition as measured by the GoStop, a visual stop-signal task.     

Difference between alcohol dependence and nicotine dependence in cognitive dysfunction]

The extent of cognitive dysfunction in the nicotine and/or alcohol dependent subjects has been evaluated with Digit Span, Number Connection Test and Wisconsin Card-Sorting Test. Samples were divided into 4 groups, 8 subjects with alcohol and nicotine dependence, 9 subjects with alcohol dependence, 10 subjects with nicotine dependence and 31 subjects without the dependences who met ICD-10 criteria for dependence syndrome. The performance times of Number Connection Test were prolonged in the alcohol dependence and the presence of the nicotine dependence did not influence the performance times of Number Connection Test. The performances on the Wisconsin Card-Sorting Test were impaired by the alcohol dependence and the presence of the nicotine dependence did not influence the performances on the Wisconsin Card-Sorting Test.     

Within-subject comparison of the psychopharmacological profiles of oral oxycodone and oral morphine in non-drug-abusing volunteers

RATIONALE: The opioid peptide beta-endorphin (beta-E) is synthesized by the pro-opiomelanocortin gene in response to environmental stressors and alcohol administration and is implicated in the behavioral sequelae associated with these stimuli. OBJECTIVES: We sought to determine the influence of beta-E on the stress response by evaluating basal measures of anxiety as well as on EtOH-induced anxiolytic behavior using transgenic mice that differ with respect to beta-E. METHODS: Anxious behavior was evaluated for male and female heterozygous, wild-type, and beta-E knockout mice using the Light-Dark Box and Plus Maze assays. Subsequent tests evaluated behavior 20 min after administration of intraperitoneal saline or EtOH (0.5, 1.0, and 1.5 g/kg). RESULTS: We observed a direct relationship between beta-E levels and the percentage of entries into open arms of the Plus Maze as well as the time spent in either the open arms or the light compartment of the Light-Dark box during basal conditions, suggesting that this peptide normally inhibits anxious behavior. However, mice lacking beta-E demonstrated an exaggerated anxiolytic response to EtOH in these assays. CONCLUSIONS: These data suggest that beta-E moderates the response to stressful stimuli and supports the hypothesis that this peptide influences the behavioral effects of EtOH.     

Interrelationship among factors associated with drinking behaviors in dental students]

We analyzed the Kurihama Alcoholism Screening Test (KAST), the Adolescent Alcohol Involvement Scale (AAIS), the Fagerstroem Tolerance Questionnaire (FTQ), the Tokyo University ALDH2-Phenotype Screening Test (TAST), results of ethanol patch tests, the presence or absence of a smoking habit, and gender by "Hayashi's quantification theory, type II" in 415 senior students (232 males and 183 females) of a dental college between 2000 and 2003, and evaluated their relationships. When drinking education is given to dental students, both the prevention of acute alcohol intoxication by chugging and the prevention of alcohol dependence in students with drinking behavior suggesting this tendency are necessary. For acute alcohol intoxication, attention can be aroused in students with positive ethanol patch tests. However, there is no definite instruction method for the prevention of alcohol dependence. Therefore, we analyzed the relationships among drinking, smoking, and constitution based on data obtained during the 4 years when the above 3 types of surveys were performed. Plotting of the results of analysis showed that the students can be classified by the ethanol patch test and TAST into those with "alcohol-sensitive" constitution and those with "alcohol-tolerant" constitution. Most problem drinkers were "alcohol-tolerant". KAST showed plotting along the constitution axis from "normal drinking group" to "problem drinking borderline group" but a change in the angle to an L shape at the transfer point from "problem drinking borderline group" to "problem drinking group", showing more serious states along the smoking axis. These results suggest that drinking behavior is first regulated by alcohol- sensitive or alcohol-tolerate constitution, and alcohol-tolerate students with a smoking habit have alcohol dependence tendency, and tend to show serious problem drinking. Improvement in the drinking habit is necessary in alcohol-tolerate students with a smoking habit so that they will not develop alcohol dependence.     

Effects of acute alcohol consumption on executive cognitive functioning in naturalistic settings

Laboratory studies have demonstrated that acute alcohol intoxication can disrupt performance on neuropsychological tests of executive cognitive functioning such as the Wisconsin Card Sorting Test (WCST). However, the generalizability of such findings to typical self-regulated alcohol intake in social settings can be questioned. In the present study, 86 young adults were recruited at Australian bars to perform a computer version of the WCST. Participants displayed blood alcohol concentrations (BACs) across a range from 0 to 0.15%. Although self-report measures of typical alcohol consumption, impulsivity, and frontal lobe related everyday functioning were all intercorrelated in line with other recent findings, multiple regression indicated that these measures did not predict perseverative errors (PE) nor non-perseverative errors (NPE) on the WCST, whereas BAC uniquely predicted PE but not NPE. The results were consistent with a dose-dependent selective disruption of prefrontal cortical functioning by alcohol. There were no differences in performance between participants tested on the ascending limb of the BAC curve and those tested on the descending limb. Alcohol-associated perseveration may reflect the inhibitory effect of alcohol-induced dopamine release in the prefrontal cortex.     

Fast screening for alcohol misuse

The Fast Alcohol Screening Test (FAST) has been developed from the AUDIT questionnaire. AUDIT: The Alcohol Use Disorders Identification Test: guidelines for use in primary health care. Geneva, Switzerland: World Health Organization for use in very busy medical settings. One feature of the FAST is its ease and speed of administration, especially since one question identifies over 50% of patients as either alcohol misusers or not. This study further explores the sensitivity and specificity of the FAST across ages, gender, and locations using the AUDIT as the gold standard. Two other quick tests are also compared with the AUDIT and the FAST, namely the Paddington Alcohol Test and the CAGE. All tests were quicker to administer than the AUDIT with the FAST taking just 12 s on average. All tests identified drinkers who would accept a health education booklet (over 70% of those identified) or 5 min of advice (over 40%). The FAST was consistently reliable when sensitivity and specificity were tested against AUDIT as the gold standard.     

Effects of desloratadine and alcohol coadministration on psychomotor performance

ABSTRACT

Objective: This study was set up to evaluate the effects of desloratadine 7.5?mg daily, with and without alcohol, on sedation and psychomotor performance.

Research methods: In a double-blind, placebo-controlled, four-way crossover trial, 25 adult patients were randomized to desloratadine 7.5?mg, desloratadine 7.5?mg plus alcohol, placebo, or placebo plus alcohol. Alcohol was weight adjusted to an average blood alcohol concentration of 0.1%. Assessments included the modified Romberg test, Stanford Sleepiness Scale, Digit Symbol Substitution Test, Serial Add Subtract Reaction Time Test, and the Psychomotor Vigilance Test. The primary variable was the mean score of each of the five tests averaged over the treatment period, expressed as the mean percent change from baseline.

Results: Across these assessments, differences between desloratadine alone or with alcohol versus placebo alone or without alcohol, were not significant, whereas most differences between desloratadine and placebo alone versus desloratadine and placebo with alcohol were significant (?p < 0.01). Thus, with or without alcohol, desloratadine 7.5?mg does not increase sedation or impair psychomotor performance. Most adverse events (AEs) were mild-to-moderate in severity, with the most frequently reported individual AEs being headache, fatigue, nausea, vomiting, and dry mouth. The study does have potential limitations. The measures used are restricted to a particular profile of the known effects of alcohol only, and the relatively high doses of alcohol used alone demonstrate effects on psychomotor function and attention.

Conclusions: A single dose of desloratadine does not potentiate alcohol-mediated CNS impairment. Desloratadine alone or in combination with alcohol was safe and well tolerated.     

Addictive Behavior Among Young People in Ukraine: A Pilot Study

The AUDIT-like tests system was created for complex assessment and evaluation of the addictive status of adolescents in a Ukrainian population. The AUDIT-like tests system has been created from the Alcohol Use Disorders Identification Test (AUDIT) developed by the World Health Organization. The AUDIT-like tests were minimally modified from the original AUDIT. Attention was brought to similarities between stages of different addictions (TV, computer games, the Internet, etc.) and alcohol addiction. Seventeen AUDIT-like tests were created to detect the different types of chemical and non-chemical addictions.     

Addictive behavior among young people in Ukraine: a pilot study

The AUDIT-like tests system was created for complex assessment and evaluation of the addictive status of adolescents in a Ukrainian population. The AUDIT-like tests system has been created from the Alcohol Use Disorders Identification Test (AUDIT) developed by the World Health Organization. The AUDIT-like tests were minimally modified from the original AUDIT. Attention was brought to similarities between stages of different addictions (TV, computer games, the Internet, etc.) and alcohol addiction. Seventeen AUDIT-like tests were created to detect the different types of chemical and non-chemical addictions.     

Executive-cognitive functioning in the development of antisocial personality disorder

The present study examined the association of cognitive-executive abilities to two risk factors for alcoholism, i.e., antisocial behaviors and a family history (FH+) of alcohol dependence. A sample of 91 right-handed, non-substance-dependent, young male adults recruited from the community were classified into three groups: (1) a control group of n=32 men with no history of DSM-III-R childhood conduct disorder (CD) or antisocial personality disorder (ASPD); (2) n=25 men who met criteria for a DSM-III-R childhood CD diagnosis, but did not meet diagnostic criteria for ASPD (i.e., CD/ASPD-); and (3) n=34 men who met DSM-III-R criteria for ASPD. They were further divided into those with and without a positive family history of alcoholism. A two-way (Antisocial Profile (3)x Family History of Alcoholism (2)) ANOVA was used to compare several neuropsychological measures of executive-cognitive functioning (ECF) ability. Verbal abstraction ability was found to be significantly lower in ASPD subjects compared with controls and CD-only subjects, inversely related to antisocial behavior severity (as measured by symptom count). CD-only and control subjects' abstraction ability were statistically indistinguishable. FH+ was associated with increased errors in planning performance on the Porteus Maze Test and diminished performance on Luria's simple alternate-tapping motor tasks. The effect was more pronounced when inhibition of prepotent motor planning was required. Results are consistent with previous work examining ECF ability in antisocial samples that find subtle differences in ECF ability compared to controls. The findings suggest that normal versus abnormal behavioral outcome for children with conduct problems may be influenced by cognitive ability profile, perhaps because of varying maturational processes.     

Chronic restraint stress induced neurobehavioral alterations and histological changes in rat

Several lines of research on human and rodent subjects have demonstrated that stress results in multiple negative outcomes, including increased incidence of psychopathologies. Restraint stress in rats is known to adversely affect the physiological, psychological and reproductive axis in rats. Male rats were subjected to restraint stress for 3 hours consecutively for 14 days. The behavioral studies include Elevated Place Maze, Open Field and Morris Water Maze tests. Our results show that chronic restraint stress involved a development of anxiety in EPM, reduced motor activity in OF, impaired memory spatial in MWM tests, and induced change in testicular function, as reflected by significant decrease in plasma level of testosterone, correlate well with the damages in testis. The Results of the present study confirm that chronic restraint stress induced cognitive dysfunction, enhance anxiety like behavior and induced testicular damage in male rats Wistar.