title: Effects of repeated withdrawal from alcohol on recovery of cognitive impairment under abstinence and rate of relapse.
abstract: OBJECTIVE
  Several authors suggest that withdrawal from alcohol could cause neurotoxic lesions in the frontal lobe and thereby affect cognitive function. In line with this, previous studies have demonstrated greater cognitive impairment of alcohol-dependent patients with two or more previous detoxifications (Hi-detox) compared with patients with less than two detoxifications (Lo-detox). The aim of the present study was to investigate whether repeated withdrawal from alcohol affects recovery of cognitive function and is related to relapse.
  
  
  METHODS
  Forty-eight alcohol-dependent patients (Hi-detox: n = 31, Lo-detox: n = 17) and 36 healthy controls underwent a comprehensive neuropsychological test-battery. Patients were tested after completion of detoxification (T1) and 3 (T2, n = 35) and 6 (T3, n = 28) months after discharge. Healthy controls were tested at T1 (n = 36) and T2 (n = 16). Drinking behaviour was assessed at all times.
  
  
  RESULTS
  Patients performed significantly worse than controls at T1 as well as T2 with regard to attention/executive function. Recovery of attention/executive function was observed within the second 3 months after discharge, but the Hi-detox group performed worse than the Lo-detox group. No association with relapse was observed.
  
  
  CONCLUSIONS
  This study provides first evidence, that repeated withdrawal from alcohol might be associated with reduced brain plasticity as indicated by a delay of recovery from impairment of attention/executive function. However, little evidence was found for a direct influence of cognitive impairment on treatment success.
authors.affiliation: Department of Addictive Behaviour and Addiction Medicine/Department of Clinical and Cognitive Neuroscience, Central Institute of Mental Health,University of Heidelberg, Mannheim, Germany. sabine.loeber@zi-mannheim.de
authors.forename: Sabine
authors.initials: S
authors.lastname: Loeber
authors.forename: Theodora
authors.initials: T
authors.lastname: Duka
authors.forename: Helga
authors.initials: H
authors.lastname: Welzel Márquez
authors.forename: Helmut
authors.initials: H
authors.lastname: Nakovics
authors.forename: Andreas
authors.initials: A
authors.lastname: Heinz
authors.forename: Karl
authors.initials: K
authors.lastname: Mann
authors.forename: Herta
authors.initials: H
authors.lastname: Flor
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000517:prevention & control / Q000523:psychology*; D003072:Cognition Disorders / Q000150:complications / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020127:Recovery of Function / Q000502:physiology; D055502:Secondary Prevention; D013375:Substance Withdrawal Syndrome / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires; D013695:Temperance / Q000523:psychology*