Neurocognition and inhibitory control in polysubstance use disorders: Comparison with alcohol use disorders and changes with abstinence.
BACKGROUND
Intact neurocognition and early cognitive recovery during abstinence are important for substance use treatment outcome. Yet, little is known about them in the largest group of treatment seekers today, individuals with polysubstance use disorders (PSU). This study primarily contrasted PSU and individuals with an alcohol use disorder (AUD) on neurocognitive and inhibitory control measures and, secondarily, measured changes during abstinence in PSU.


METHODS
At one month of abstinence from all substances except tobacco, 36 PSU and 69 AUD completed neurocognitive assessments of executive function, general intelligence, auditory-verbal learning/memory, visuospatial learning/memory/skills, processing speed, working memory, fine motor skills, and cognitive efficiency. The groups were also assessed on inhibitory control measures of self-reported impulsivity, risk-taking, and decision-making. Seventeen PSU repeated the assessments after approximately four months of abstinence. All cross-sectional and longitudinal analyses included smoking status as a possible confound.


RESULTS
At baseline, PSU performed significantly worse than AUD on auditory-verbal memory and on an inhibitory control measure of impulsivity. Polysubstance users showed trends to worse performance than AUD on general intelligence, auditory-verbal learning, and a decision-making task. Between one and four months of abstinence, PSU showed significant improvements on several neurocognitive and inhibitory control measures.


CONCLUSIONS
Polysubstance users exhibit distinct differences in neurocognition and inhibitory control compared to AUD. Between one and four months of abstinence, neurocognition and inhibitory control improve in PSU. This neurocognitive recovery in some domains of abstinent PSU is influenced by smoking status. These results underscore the clinical value of select methods to augment neurocognitive recovery in PSU through appropriate interventions.
a Department of Radiology , Northern California Institute for Research and Education , San Francisco , CA , USA.|b Department of Radiology , San Francisco Veterans Affairs Medical Center , San Francisco , CA , USA.
Thomas P
TP
Schmidt
a Department of Radiology , Northern California Institute for Research and Education , San Francisco , CA , USA.|b Department of Radiology , San Francisco Veterans Affairs Medical Center , San Francisco , CA , USA.|c Department of Psychiatry , University of California , San Francisco , CA , USA.
David L
DL
Pennington
b Department of Radiology , San Francisco Veterans Affairs Medical Center , San Francisco , CA , USA.|c Department of Psychiatry , University of California , San Francisco , CA , USA.
Stephanie L
SL
Cardoos
d Department of Psychiatry and Behavioral Sciences , Stanford University , Stanford , CA , USA.|e Department of Psychiatry , Veterans Affairs Palo Alto Health Care System , Palo Alto , CA , USA.
Timothy C
TC
Durazzo
a Department of Radiology , Northern California Institute for Research and Education , San Francisco , CA , USA.|b Department of Radiology , San Francisco Veterans Affairs Medical Center , San Francisco , CA , USA.|f Department of Radiology and Biomedical Imaging , University of California , San Francisco , CA , USA.
Dieter J
DJ
Meyerhoff
D000328:Adult; D000437:Alcoholism / Q000523:psychology*; D003071:Cognition / Q000502:physiology*; D003430:Cross-Sectional Studies; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000502:physiology; D007266:Inhibition, Psychological; D007360:Intelligence / Q000502:physiology; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D012309:Risk-Taking; D012907:Smoking / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology*; D013695:Temperance
Addiction; Cognition; Impulsivity; Longitudinal; Recovery; Substance use disorders
Arch Clin Neuropsychol. 2014 Feb;29(1):26-37
24334264
J Stud Alcohol. 1982 Nov;43(11):1157-70
7182675
Alcohol Clin Exp Res. 1994 Aug;18(4):867-72
7978097
Addict Biol. 2009 Jan;14(1):22-31
18855805
Addict Behav. 2014 Nov;39(11):1632-9
24864028
Exp Clin Psychopharmacol. 1998 Aug;6(3):292-305
9725113
Neuropsychopharmacology. 2008 Mar;33(4):827-36
17568399
Curr Opin Psychiatry. 2014 Jul;27(4):269-75
24852056
Rev Neurosci. 2014;25(1):1-24
24361772
J Exp Psychol Appl. 2002 Jun;8(2):75-84
12075692
Subst Abuse Treat Prev Policy. 2007 Nov 08;2:33
17996066
Alcohol Clin Exp Res. 2014 Nov;38(11):2816-25
25336410
Alcohol Alcohol. 2013 Sep-Oct;48(5):543-51
23797281
Am J Addict. 2005 Mar-Apr;14(2):166-78
16019965
Alcohol Alcohol. 2007 May-Jun;42(3):174-85
17526627
Alcohol Clin Exp Res. 2016 Jan;40(1):152-60
26683585
Drug Alcohol Depend. 2006 Feb 28;81(3):313-22
16171953
Arch Intern Med. 2003 Nov 10;163(20):2511-7
14609789
J Psychopharmacol. 2010 Sep;24(9):1317-32
20007413
JAMA. 2000 Oct 4;284(13):1689-95
11015800
Clin Psychol Rev. 2014 Nov;34(7):531-50
25240109
Alcohol Clin Exp Res. 2013 Jul;37(7):1220-7
23432133
PLoS One. 2015 Mar 24;10(3):e0122505
25803861
Drug Alcohol Depend. 2002 Sep 1;68(1):87-93
12167554
J Consult Clin Psychol. 1978 Dec;46(6):1258-65
730876
Alcohol Clin Exp Res. 2004 Dec;28(12):1849-60
15608601
Psychiatry Res. 2012 Aug-Sep;203(2-3):214-21
22959812
Eur J Pharmacol. 2010 Jan 10;626(1):104-12
19836375
Drug Alcohol Depend. 2014 Nov 1;144:170-7
25263262
Alcohol Clin Exp Res. 2010 Jun;34(6):1073-83
20374206
Front Psychiatry. 2014 Jul 16;5:78
25076914
Alcohol. 2006 May;39(1):1-11
16938624
Alcohol Clin Exp Res. 1998 Oct;22(7):1414-20
9802522
Br J Addict. 1988 Apr;83(4):393-402
3395719
Alcohol Clin Exp Res. 2005 Jun;29(6):989-98
15976525
West J Med. 1990 May;152(5):531-7
2190421
Alcohol Clin Exp Res. 2015 Oct;39(10 ):1989-96
26365044
J Clin Psychol. 1995 Nov;51(6):768-74
8778124
Ear Nose Throat J. 1990 Nov;69(11):763-5
2276350
Stat Med. 1997 Nov 30;16(22):2529-42
9403954
Handb Clin Neurol. 2014;125:183-210
25307576
Biomed Pharmacother. 2004 Mar;58(2):77-83
14992787
Pharmacol Biochem Behav. 2002 Oct;73(3):491-504
12151022
Drug Alcohol Depend. 2015 May 1;150:120-8
25772434
Drug Alcohol Depend. 2008 Apr 1;94(1-3):82-91
18063322
Exp Clin Psychopharmacol. 2002 Aug;10(3):193-212
12233981
Exp Clin Psychopharmacol. 2016 Feb;24(1):30-7
26691847
Alcohol Clin Exp Res. 2000 May;24(5):611-21
10832902
J Clin Exp Neuropsychol. 1991 Nov;13(6):933-49
1779032
Addiction. 2009 Jan;104(1):38-48
19133887
Am J Addict. 2005 Mar-Apr;14(2):106-23
16019961
Drug Alcohol Depend. 2016 Feb 1;159:61-5
26684868
Arch Clin Neuropsychol. 2001 Jan;16(1):1-8
14590188
Neuropsychol Rev. 2013 Mar;23(1):27-47
23412885
Arch Clin Neuropsychol. 1997;12(7):667-76
14590660