Neurocognitive effects of alcohol hangover

Alcohol hangover is characterized by adverse physical and mental effects that occur the next morning after the intake of toxic doses of alcohol. One of the more relevant functional consequences of hangover is the cognitive and subjective impairment, which could be related to the high socioeconomic costs of alcohol consumption. Nevertheless, few studies have addressed the study of neurocognitive and subjective effects of hangover. The systematic and exhaustive study of neurocognitive and subjective effects has not been done. In the present work we briefly review the hangover impact, not only in the objective execution of attention, psychomotricity and memory tasks, but in the subjective state of the subjects as well. Moreover, we also highlight the methodology difficulties to study neurocognitive effects of hangover and suggest several aspects to take into account in future investigations.     

Stimulant alcohol effects prime within session drinking behavior

Rationale Individual differences in subjective alcohol effects have been shown to differ by risk status (e.g., family history of alcoholism) and to predict future risk for alcohol-related problems. Presumably, individual differences in both stimulant and sedative responses affect the rewarding value of drinking which, in turn, impacts future drinking behavior. Although plausible, this theoretical model is largely untested. Objectives The current study attempted to provide experimental evidence for the impact of subjective alcohol responses on within session drinking behavior. Materials and methods Using a placebo-controlled between-subjects alcohol administration paradigm, experiences and evaluations of stimulant and sedative alcohol effects (after a target dose of 0.06 g%) were assessed as predictors of ad-libitum consumption in the context of anticipatory stress. Results Analyses indicated that an initial dose of alcohol increased experiences of both stimulation and sedation although stimulant effects were evaluated much more positively. In addition, stimulant effects after a priming dose predicted further consumption, whereas sedative effects did not. Conclusions At least among moderate to heavy drinking college students, stimulant alcohol effects are more reinforcing and predict within session drinking behavior under social stress. Increased attention should be given to stimulant alcohol effects as a risk factor for excessive consumption in this population. Incorporating information about stimulant alcohol effects in prevention and intervention programs may also be important if additional research supports the current results. This research has been supported by grants from the Texas Commission of Alcohol and Drug Abuse (517-9-8444), the National Institute on Alcohol Abuse and Alcoholism (5T32-AA07471; RO1-AA11683) the Co-operative Society at The University of Texas at Austin, and the Waggoner Center for Alcohol and Addiction Research.     

The measurement of drinking patterns and alcohol problems in Nigeria

As in most other societies, alcoholic beverages have been consumed in what is present-day Nigeria for a long time. Before the arrival of western factory-made drinks, alcohol consumption was limited to a variety of beverages produced from palm trees and food grains. Today, beer has become the most popular drink in the country but traditional beverages (palm wine, burukutu, ogogoro, pito) are still widely consumed in both rural and urban areas. Though research has shown that heavy drinking seems to be the norm among those who drink any type of alcohol, there is no clear association between drinking and social or health problems. On the other hand, certain types of beverages are linked with positive attributes. Despite their potential significance, these and other issues have not received the attention they deserve in the alcohol research literature on Nigeria and other African countries. The focus of this paper is on the need to take into consideration relevant measurement issues (e.g., container and serving size, alcohol contents, drinking expectancies, perceived risks associated with the consumption of different types of alcoholic beverages, as well as reasons for drinking) in alcohol research. It is suggested that a better understanding of these and related factors is necessary for the advancement of alcohol epidemiology in the country.     

Prostaglandins in alcohol intolerance and hangover

The effects of alcohol on the formation of prostaglandins (PGs) and the blockade of some actions of alcohol by PG-inhibitors suggest that PGs may be involved in the action of ethyl alcohol. Regulation of lipid peroxidation and synthesis and release of precursor fatty acids may affect the overall formation of PGs. The effect of alcohol may be qualitative for several reasons: (i) the possible preferred formation of 1-series of PGs would mean an important qualitative change in PG-impact in some tissues; (ii) inhibition of PG-metabolism in the lung might affect mostly the plasma levels of PGE; (iii) a selective blockade of certain PG-effects and a potentiation of some others gives rise to qualitative changes in the actions of PGs. PGs may be involved in several acute or short-term reactions caused by alcohol. Chlorpropamide-alcohol flush, alcohol intolerance and hangover are effectively alleviated by a prophylactic use of PG-inhibitors. Speculatively PGs might also be involved in migraine attacks provoked by alcohol and in antabuse in reaction. The roles of PGs in the regulation of vascular tone, water and electrolyte balance as well as in certain secretory and metabolic processes may be important in the generation of alcohol related reactions.     

The age of drinking onset and housing condition influences rat alcohol drinking behavior.

We investigated whether age of drinking onset and/or the housing condition in experimental animals affected alcohol drinking behavior to extrapolate the experimental findings to alcohol drinking patterns of aged people. At the time of the experiments, all 1-, 4-, 10- and the 16-month-old rats were divided into two groups, isolated and aggregated groups, and then maintained in the same housing conditions for six months. The amounts of voluntary alcohol consumption (g/kg/day) of all rats were investigated by two-bottle methods at 7, 10, 16 and 22 months old. No significant difference in alcohol drinking behavior was shown in the 7- and 10-month-old rats. A decrease in voluntary alcohol consumption was shown in the 16-month-old rats of the aggregated groups. In the 22-month old rats, a significant suppression of voluntary alcohol consumption was found in the aggregated groups compared with the isolated group. The results demonstrate that an important determinant of EtOH intake is related to environmental factors. It was suggested that alcohol drinking behavior strongly depends on the housing conditions and the age of onset of alcohol drinking.     

Serotonin mechanisms in alcohol drinking behavior

Rat lines selectively bred for disparate alcohol-drinking behaviors exhibit innate differences in the contents of serotonin (5-HT) in several CNS limbic regions, e.g., nucleus accumbens (ACB), frontal cortex, hypothalamus, and olfactory tubercles. In these regions, the selectively bred alcohol-preferring (P) line has levels approximately 20% (P > 0.05) lower than values obtained for the alcohol-nonpreferring (NP) line. In addition, in some limbic regions, the densities of (1) 5-HT_1A receptors are higher by approximately 30% and (2) 5-HT_1B and 5-HT₂ receptors are lower (by 25-40%) in the P than in the NP line. systemic administration of agents that increase synaptic levels of 5-HT, such as fluoxetine (a 5-HT uptake inhibitor), d-fenfluramine (a 5-HT releaser) and D, L-5-hydroxytryptophan (an immediate precursor of 5-HT), significantly decreased alcohol consumption of the P line of rats. Systemic (1.0 and 2.0 g/kg ip) administration or local perfusion (100 mM) of ethanol significantly increased the extracellular levels of 5-HT in the ACB of unselected Wistar rats. An interaction of the dorsal raphe nucleus (DRN) 5-HT system with the ventral tegmental area (VTA) dopamine (DA) pathway projecting to the ACB was indicated by the findings that DA release in the ACB increased and decreased following stimulation and inhibition, respectively, of DRN 5-HT neurons. Moreover, an involvement of 5-HT in mediating alcohol-stimulated DA release in the ACB is indicated by the observation that local application of a 5-HT₃ antagonist can attenuate this stimulated release. Overall, the data suggest that an innate 5-HT deficiency in certain limbic structures of the P rat may be a major neurobiological factor underlying their high alcohol drinking characteristics. © 1993 wiley-Liss, Inc.     

Subjective alcohol effects and drinking behavior: the relative influence of early response and acquired tolerance

OBJECTIVES: (1) To establish the reliability and validity of a modified version of the Self-Rating of Alcohol (SRE) form. (2) To differentiate early subjective alcohol response (SR) from acquired tolerance in the prediction of drinking outcomes. METHOD: 353 undergraduates completed an online survey. SR was assessed using the SRE form and a modified SRE including items assessing global stimulant and sedative effects. The Daily Drinking Questionnaire-Revised (DDQ-R), and the Rutgers Alcohol Problems Index (RAPI) assessed alcohol use and problems, respectively. RESULTS: The revised version of the SRE showed good internal consistency and incremental validity. Early SR assessed by the modified SRE was consistently associated with use and problems. Acquired tolerance was significantly related to use and problems above and beyond early SR. CONCLUSIONS: The modified SRE incorporating stimulant and sedative responses demonstrated good psychometric properties and the potential to capture unique variability in drinking outcomes. Differentiating early SR from tolerance showed that each contributes uniquely to drinking behavior and problems. Thus, future studies would benefit from examining the unique contribution of each aspect of SR.     

Alcohol hangover effects on memory functioning and vigilance performance after an evening of binge drinking.

The impairing effects on memory functioning after acute alcohol intoxication in healthy volunteers and after chronic use in alcoholics are well established. However, research determining the next-morning effects of a single episode of binge drinking on memory functioning is scarce. A total of 48 healthy volunteers participated in a single-blind study comprising an evening (baseline) session, followed by a treatment administration (ethanol 1.4 g/kg or placebo), and a morning session. Memory was tested with a word-learning test (including immediate and delayed recall, and recognition). Further, a 45-min Mackworth clock test for measuring vigilance was included (parameters: number of hits and false alarms) and subjective alertness was assessed, to infer whether word-learning test findings reflect sedation or specific memory impairments. Delayed recall in the morning session was significantly worse in the alcohol group when compared to the placebo group (F(1,42)=6.0, p<0.02). In contrast, immediate recall and recognition were unimpaired in the alcohol group. In the morning session, relative to the placebo group, subjective alertness was significantly reduced in the alcohol group before and after the tests (F(1,44)=8.7, p<0.005; F(1,44)=13.3, p&<0.001, respectively). However, in the Mackworth clock test, the alcohol group and placebo group did not differ significantly in the morning session. The specific findings of impaired delayed recall show that memory retrieval processes are significantly impaired during alcohol hangover. Vigilance performance was not significantly affected, indicating that this memory impairment does not reflect sedation.     

The role of the controlled drinking goal in the prevention of alcohol problems

The role of the controlled drinking goal is examined in relation to the three traditional levels of preventive activity — primary, secondary and tertiary. It is shown that this goal of intervention, and the methods of behaviour change associated with it, have important potential applications at each of these levels. An integrated approach to treatment and prevention, based on a social learning perspective on drinking behaviour and problems, is recommended.     

Age, drinking habits and the effects of alcohol

Some explanations for the common observation that older persons drink less alcohol than younger persons were tested in a sample of 41 men social drinkers aged 19-63. Subjects reported their drinking habits and performed balance beam and bead-stringing tasks under a moderate dose of alcohol (.72 ml absolute alcohol/kg). Self-reports of dose (ml absolute alcohol/kg) on a typical social occasion, and hourly dose (which controlled for individual differences in the duration of these occasions) were found to decline linearly with age. Alcohol absorption and elimination rates in the sample were not significantly related to age. The Ponderal Index (an estimate of percentage of body water in body weight) was negatively correlated with age and with peak blood alcohol levels (BALs). Older subjects had proportionately less body water (i.e., a smaller volume for distribution of alcohol) and obtained higher BALs. When individual differences in BAL were controlled for, the amount of alcohol-induced impairment in task performance was still found to increase significantly with age. This evidence was considered to suggest that a reduction in the volume of distribution for alcohol and an intensified behavioral effect of alcohol may operate jointly to cause older persons to reduce their dose of alcohol on social drinking occasions.     

Using the Extrinsic Affective Simon Test as a measure of implicit attitudes towards alcohol: relationship with drinking behavior and alcohol problems

In apparent contrast to the alleged importance of positive alcohol expectancies in alcohol (ab)use, a series of studies using the Implicit Association Test (IAT; [Greenwald, A. G., McGhee, D. E., & Schwartz, J.L.K. (1998). Measuring individual differences in implicit cognition: The Implicit Association Test. Journal of Personality and Social Psychology, 74, 1464-1480]), found that heavy and light drinkers display more negative implicit attitudes toward alcohol than toward sodas (e.g., [Wiers, R. W., van Woerden, N., Smulders, F. T. Y., & de Jong, P. J. (2002). Implicit and explicit alcohol-related cognitions in heavy and light drinkers. Journal of Abnormal Psychology, 111, 648-658]). One explanation for this might be that the negative-alcohol IAT effect reflects an artifact of the IAT procedure and are due to its relative nature and/or its sensitivity to task recoding strategies. Therefore, the present study used a non-relative measure that has been argued to be robust against participants' task recoding strategies (Extrinsic Affective Simon Test; EAST, [De Houwer, J. (2001). A structural and process analysis of the Implicit Association Test. Journal of Experimental Social Psychology, 37, 443-451]) to test heavy (n=16) and light (n=16) drinkers' automatic affective associations with alcohol and sodas. Heavy and light drinkers displayed clear positive associations with sodas and neutral (or ambivalent) automatic associations with alcohol. Importantly, positive automatic alcohol associations predicted unique variance of alcohol (mis)use and was the single best predictor of individuals' alcohol problems, underlining the idea that they do play a role in alcohol (mis)use.     

The impact of alcohol hangover symptoms on cognitive and physical functioning,and mood

Hangover research often records the presence and severity of symptoms experienced the day after heavy alcohol consumption. However, usually no information is gathered on the impact of experiencing these symptoms on mood, cognition, and physical activities. An online survey was held among Dutch students, aged 18–30 years, who recently had a hangover. Overall hangover severity (i.e., a single 1‐item rating) and the severity of 22 individual symptoms were rated on an 11‐point scale ranging from 0 (absent ) to 10 (extreme ). In addition, for each symptom, participants were asked to rate their respective negative impact on (a) cognitive functioning, (b) physical functioning, and (c) mood, on a 6‐point Likert scale ranging from 0 (no impact ) to 5 (extreme ). N  = 1837 subjects completed the survey. The mean (SD ) overall (1‐item) hangover severity score was 6.1 (1.9). Sleepiness, being tired, thirst, and concentration problems were the most frequently reported hangover symptoms. These symptoms also reached the highest severity scores (ranging from 6.3 to 7.0). The 4 symptoms with the biggest combined impact on mood, and cognitive and physical functioning were being tired, sleepiness, headache, and concentration problems. In conclusion, whereas severity and impact scores usually correspond well, some frequently reported symptoms with moderate to high severity scores had little impact on mood, and cognitive and physical functioning (i.e., reduced appetite, regret, and thirst).     

Effects of alcohol hangover on simulated highway driving performance

Background

The purpose of this study was to examine the effects of alcohol hangover on simulated highway driving performance.

Methods

Driving performance of forty-two social drinkers was tested the morning following an evening of consuming on average 10.2 (SD?=?4.2) alcoholic drinks (alcohol hangover) and on a control day (no alcohol consumed). Subjects performed a standardized 100-km highway driving test in the STISIM driving simulator. In addition to the standard deviation of lateral position (SDLP; i.e., the weaving of the car), lapses of attention were examined. Self-reported driving quality and driving style were scored, as well as mental effort to perform the test, sleepiness before and after driving, and hangover severity.

Results

Driving performance was significantly impaired during alcohol hangover as expressed by an SDLP increase of +1.9 cm (t _(1,41)?=?2.851, p?=?0.007), increased number of lapses relative to the control day (7.7 versus 5.3 lapses, t _(1,41)?=?2.125, p?=?0.019), and an increased total lapse time (182.7 versus 127.3 s, p?=?0.040). During alcohol hangover, subjects reported their driving quality to be significantly poorer (t _(1,41)?=?4.840, p?=?0.001) and less safe (t _(1,41)?=?5.078, p?=?0.001), wise (t _(1,41)?=?4.061, p?=?0.001), predictable (t _(1,41)?=?3.475, p?=?0.001), and responsible (t _(1,41)?=?4.122, p?=?0.001). Subjects further reported being significantly more tense while driving (t _(1,41)?=?3.280, p?=?0.002), and more effort was needed to perform the driving test (t _(1,41)?=?2.941, p?=?0.001). There was a significant interaction with total sleep time and hangover effects on SDLP and the number of lapses.

Conclusions

In conclusion, driving is significantly impaired during alcohol hangover, as expressed in an elevated SDLP and increased number of lapses. Total sleep time has a significant impact on the magnitude of driving impairment.     

The impact of current residence and high school drinking on alcohol problems among college students

OBJECTIVE: This study examines relationships between type of (current) residence, heavy episodic drinking in high school and alcohol-related problems among college students. METHOD: The study participants were respondents in the 1993, 1997 and 1999 Harvard School of Public Health College Alcohol Study (CAS) surveys of students attending 119 4-year U.S. colleges. Based on responses from 6,525 (55.6% female) students in the 1993 CAS, an exploratory factor analysis of the alcohol problem items was specified in a confirmatory factor analysis framework based on a four-factor solution, and related to study variables. The 1993 data were cross-validated with the 1997 and 1999 surveys. RESULTS: When compared with students living in single-gender dormitories, students living off campus with parents reported lower alcohol-related problem consequences and a higher probability of drinking/driving. Students residing off campus without parents, compared with students in single-gender dorms, reported a higher probability of drinking/driving. Associations between off-campus residence and probabilities for drinking/driving were mediated by frequency of driving. Students living in coed dormitories, when compared with students in single-gender dorms, incurred more problem consequences related to drinking but reported significantly lower probabilities associated with designated driving and drinking/driving. Heavy episodic drinking in high school was related to higher probabilities of problems on all outcome measures. CONCLUSIONS: The presence of direct and independent effects for both heavy drinking prior to college and high-risk environmental factors in collegiate drinking practices support targeted and diverse strategies for prevention activities.     

The effects of alcohol on agonistic behavior in the Telomian dog

The study analyzed the effects of alcohol on agonistic behavior in three independent social systems, each compromised of two male and one female Telomian dog. Three dose levels were used: 0, 0.8, and 1.6 g/kg body weight of absolute alcohol diluted to 20%. Observations were made when none, one (top, middle or low ranking), or all dogs in a system received a given treatment. At the 0.8 g/kg level, low ranking dogs showed an increased frequency of attacks and bone possession time, while top and middle ranking dogs showed a decrease. At the 1.6 g/kg level, all subjects decreased their attacks and bone possession time. Alcohol decreased frequency of agonistic vocalizations under all conditions. There were differential social rank effects on frequency of retreats. Overall, the results were similar whether one or all dogs received the particular treatment.     

The effects of alcohol and atropine on EEG and behavior in the rabbit

Electroencephalographic (EEG) activity was recorded from hippocampus and neocortex of rabbits. It was found that movement, movement-related 6–12 Hz rhythmical slow actvity (RSA), and movement-related neocortical desynchronization were unaffected by intravenous atropine sulfate but depressed by ethyl alcohol (ethanol). Slower 4–8 Hz immobility-related RSA and immobility-related neocortical desynchronization produced by sensory stimulation (visual, auditory, tactle, vestibular) were relatively unaffected by ethanol even at high (0.1–0.2 g-%) blood alcohol levels, but were abolished by atropine sulfate. The results provide evidence for the idea of two pharmacologically separable cortical activating systems and suggest that ethanol has a greater effect on noncholinergic than cholinergic systems.     

A critical analysis of alcohol hangover research methodology for surveys or studies of effects on cognition

Rationale

Alcohol hangover may be defined as an adverse effect of heavy alcohol consumption present after sufficient time has elapsed for the alcohol to have been eliminated from the blood. Understanding how hangover may impair performance is important for public safety; yet, there is relatively little hangover research. This paper outlines good practice for future studies.

Objectives

This paper presents a critical analysis of hangover methodology for surveys or studies of effects on cognition with human subjects and provides suggestions for optimum research practice for laboratory-based and naturalistic alcohol hangover studies.

Results

Four hangover symptom scales have been developed and subjected to psychometric testing. For retrospective assessment, we recommend the Hangover Symptoms Scale (HSS) or the Alcohol Hangover Severity Scale (AHSS). For concurrent assessment of hangover symptoms, we recommend either the Acute Hangover Scale (AHS), the five-item version of the HSS, or the AHSS. In research aiming to assess the cognitive effects of alcohol hangover, we suggest focusing on the cognitive domains of attention, memory and executive function, and we specify a number of tests within these cognitive domains that are likely to be sensitive to any decrements due to hangover. Finally, we argue that naturalistic studies should assess biological markers to improve the accuracy of estimates of alcohol consumption. Specifically, we recommend the assessment of ethyl glucuronide (EtG) for this purpose.

Conclusions

Recommendations are made with respect to assessing hangover symptoms, cognitive effects of hangover and biological markers of alcohol consumption.