Clinical and Biological Risk Factors for Neuropsychological Impairment in Alcohol Use Disorder.
The effects of alcoholism on cognitive and motor functioning are heterogeneous. While the role of some factors (patterns of alcohol consumption, eating habits or associated liver disease) has been hypothesized, the origins of this heterogeneity remain difficult to establish. The goals of the present study were thus to identify the clinical and biological risk factors for alcohol-related neuropsychological impairments and to determine the threshold beyond which these risk factors can be considered significant. Thirty alcoholic patients and 15 healthy controls had a blood test and underwent a neuropsychological examination. Alcohol severity measures, and liver, thiamine and malnutrition variables, were included in logistic regression models to determine the risk factors for cognitive and motor impairments (executive functions, visuospatial abilities, verbal episodic memory, ataxia), as well as those related to the severity of patients' overall neuropsychological profile (moderate or severe impairments). Liver fibrosis was found to be a risk factor for executive impairments and also for ataxia, when it was associated with long-term alcohol misuse and symptoms of withdrawal. Altered thiamine metabolism was solely predictive of verbal episodic memory impairments. This combination of biological abnormalities was associated with a profile of moderate neuropsychological impairments. Malnutrition was associated with a profile of more severe impairments. Malnutrition, altered liver function and thiamine metabolism explain, at least partially, the heterogeneity of alcohol-related neuropsychological impairments. Our findings could allow clinicians to identify patients at particular risk of severe neuropsychological impairments before the onset of irreversible and debilitating neurological complications.
U1077, INSERM, Caen, France.|UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France.|UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France.|U1077, Centre Hospitalier Universitaire, Caen, France.
Ludivine
L
Ritz
Centre Hospitalier Universitaire, Laboratoire de biochimie, Caen, France.|Université de Caen Normandie, Laboratoire EA4650, Caen, France.
Laurent
L
Coulbault
U1077, INSERM, Caen, France.|UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France.|UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France.|U1077, Centre Hospitalier Universitaire, Caen, France.
Coralie
C
Lannuzel
U1077, INSERM, Caen, France.|UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France.|UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France.|U1077, Centre Hospitalier Universitaire, Caen, France.|Centre Hospitalier Universitaire, service d'addictologie, Caen, France.
Céline
C
Boudehent
U1077, INSERM, Caen, France.|UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France.|UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France.|U1077, Centre Hospitalier Universitaire, Caen, France.
Shailendra
S
Segobin
U1077, INSERM, Caen, France.|UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France.|UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France.|U1077, Centre Hospitalier Universitaire, Caen, France.
Francis
F
Eustache
U1077, INSERM, Caen, France.|UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France.|UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France.|U1077, Centre Hospitalier Universitaire, Caen, France.|Centre Hospitalier Universitaire, service d'addictologie, Caen, France.
François
F
Vabret
U1077, INSERM, Caen, France.|UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France.|UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France.|U1077, Centre Hospitalier Universitaire, Caen, France.
Anne Lise
AL
Pitel
U1077, INSERM, Caen, France.|UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France.|UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France.|U1077, Centre Hospitalier Universitaire, Caen, France.
Hélène
H
Beaunieux
D000328:Adult; D000437:Alcoholism / Q000523:psychology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors