Contribution of frontal cerebral blood flow measured by (99m)Tc-Bicisate spect and executive function deficits to predicting treatment outcome in alcohol-dependent patients.
OBJECTIVE
To determine whether inhibition and working memory deficits, and reduced regional cerebral blood flow (rCBF) (previously shown to be related), measured at the end of a detoxification programme, predict alcoholic relapse 2 months later.


METHODS
Twenty uncomplicated alcoholic inpatients were investigated at the end of detoxification, at least 7 days since the last dose of diazepam, and a mean of 18.8 days since the last drink. Their performance was assessed on the inhibition (Hayling) test, working memory (Alpha-span task), episodic memory (California Verbal Learning Test) and abstract reasoning (Progressive Matrices). Frontal CBF was assessed at the same time with a semiquantitative (99m)Tc-Bicisate SPECT procedure. Patients were contacted 2 months later. Patients who abstained (n = 9) did not differ from those who relapsed (n = 11) on age, gender, smoking, duration of alcohol misuse, number of previous detoxifications, amount of ethanol consumed the month prior to admission to the detoxification programme, state anxiety, trait anxiety, or depression.


RESULTS
Relapsed subjects had shown a lower uptake of (99m)Tc-Bicisate in the bilateral medial frontal gyrus (n = 9; mean ratio +/- SD = 0.69 +/- 0.006) than abstainers (n = 11; 0.85 +/- 0.19), and poorer performance on the Alpha-span task and the Hayling test. The other tests were not different.


CONCLUSIONS
Inhibition and working memory deficits, associated with low levels of CBF in the medial frontal gyrus, are related to the difficulty of maintaining short-term abstinence from alcohol.
Noël
Xavier
X
Departments of Psychiatry and Nuclear Medicine, Free University of Brussels, Brugmann Hospital, Belgium and Department of Cognitive Psychopathology, University of Geneva, Geneva, Switzerland.
Sferrazza
Rita
R
Van Der Linden
Martial
M
Paternot
Jacques
J
Verhas
Michel
M
Hanak
Catherine
C
Pelc
Isidore
I
Verbanck
Paul
P
D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000000981:diagnostic imaging*; D000704:Analysis of Variance; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000000981:diagnostic imaging*; D008875:Middle Aged; D013667:Technetium; D013695:Temperance / Q000523:psychology; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
D013667:Technetium