Mélanie Brion1, Fabien D'Hondt2, Anne-Lise Pitel3, Benoît Lecomte4, Marc Ferauge5, Philippe de Timary6, Pierre Maurage7. 1. Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain,10 Place C. Mercier, B-1348 Louvain-la-Neuve, Belgium. 2. Univ. Lille, CNRS UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, psyCHIC team,1 Place de Verdun, F-59045 Lille, France; CHU Lille, Clinique de Psychiatrie, CURE, F-59000, Lille, France. 3. INSERM, École Pratique des Hautes Études, Université de Caen-Normandie, Unité U1077, GIP Cyceron, CHU Caen, F-14000 Caen, France. 4. Department of Neuropsychiatry, Saint-Martin Hospital, 84 rue Saint-Hubert, B-5100 Dave, Belgium. 5. Department of Addiction Rehabilitation, Beau-Vallon Hospital, 205 rue de Bricgniot, B-5002 Saint-Servais, Belgium. 6. Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain,10 Place C. Mercier, B-1348 Louvain-la-Neuve, Belgium; Department of Adult Psychiatry, St Luc Hospital and Institute of Neuroscience, Université catholique de Louvain,10 Avenue Hippocrate, B-1200 Brussels, Belgium. 7. Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain,10 Place C. Mercier, B-1348 Louvain-la-Neuve, Belgium. Electronic address: pierre.maurage@uclouvain.be.
Abstract
BACKGROUND: Alcohol-dependence is related to large-scale cognitive impairments, particularly for executive functions (EF). These deficits persist even after long-term abstinence and have a major impact on patients' everyday life and relapse risk. Earlier studies, based on multi-determined tasks, mostly focused on inhibition and did not offer a theoretically-grounded and exhaustive view of the differential deficit across EF. The present paper proposes a model-based exploration of EF in alcohol-dependent individuals (ALC), to precisely compare the specific deficit related to each executive subcomponent. METHODS: Forty-seven recently detoxified ALC were compared to 47 matched healthy participants on a nine-tasks validated neuropsychological battery, simultaneously exploring and comparing the three main executive subcomponents (shifting, updating, and inhibition). Psychopathological comorbidities were also controlled for. RESULTS: Reaction time indexes revealed a global slowing down among ALC, whatever the EF explored. Accuracy indexes revealed a moderate deficit for inhibition tasks but a massive impairment for shifting and updating ones. Complementary analyses indicated that the executive deficits observed were centrally related to alcohol-dependence, while comorbid depressive symptoms appeared to intensify the deficits observed. CONCLUSIONS: By offering a direct comparison between the three major EF, these results showed that alcohol-related executive deficits extend beyond the classically described inhibition impairment. This impairment encompasses each EF subcomponent, as ALC actually presented stronger deficits for updating and shifting abilities. This first observation of a multifaceted EF deficit stresses the need for an individualized evaluation and rehabilitation of EF during and/or after the detoxification process.
BACKGROUND:Alcohol-dependence is related to large-scale cognitive impairments, particularly for executive functions (EF). These deficits persist even after long-term abstinence and have a major impact on patients' everyday life and relapse risk. Earlier studies, based on multi-determined tasks, mostly focused on inhibition and did not offer a theoretically-grounded and exhaustive view of the differential deficit across EF. The present paper proposes a model-based exploration of EF in alcohol-dependent individuals (ALC), to precisely compare the specific deficit related to each executive subcomponent. METHODS: Forty-seven recently detoxified ALC were compared to 47 matched healthy participants on a nine-tasks validated neuropsychological battery, simultaneously exploring and comparing the three main executive subcomponents (shifting, updating, and inhibition). Psychopathological comorbidities were also controlled for. RESULTS: Reaction time indexes revealed a global slowing down among ALC, whatever the EF explored. Accuracy indexes revealed a moderate deficit for inhibition tasks but a massive impairment for shifting and updating ones. Complementary analyses indicated that the executive deficits observed were centrally related to alcohol-dependence, while comorbid depressive symptoms appeared to intensify the deficits observed. CONCLUSIONS: By offering a direct comparison between the three major EF, these results showed that alcohol-related executive deficits extend beyond the classically described inhibition impairment. This impairment encompasses each EF subcomponent, as ALC actually presented stronger deficits for updating and shifting abilities. This first observation of a multifaceted EF deficit stresses the need for an individualized evaluation and rehabilitation of EF during and/or after the detoxification process.