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Repeated Detox Can Impair Cognitive Function

Multiple Withdrawals Can Damage Frontal Lobe

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Updated October 15, 2003

Researchers and clinicians know that patients undergoing alcohol detoxification are more likely to experience seizures if they have undergone previous episodes of detoxification. Prior research has also indicated that multiple withdrawals may lead to changes in brain functioning.

A study in the October 2003 issue of Alcoholism: Clinical & Experimental Research confirms previous findings of neurocognitive changes in alcoholics, extends those findings to individuals with mild to moderate alcoholism, and demonstrates a relationship of those changes to multiple withdrawals.

"Results from this study support previous findings of impaired frontal-lobe function in alcoholics," said Theodora Duka, associate professor at the University of Sussex and first author of the study. "Our study adds to that by showing that such impairments can be found also in non-severe alcoholics. But its major contribution to the field is that the number of detoxifications that patients experience contributes significantly to these impairments."

"Some clinicians tend to ignore the issue of multiple withdrawals, whereas other clinicians feel they're important, having come to realize that patients who have had multiple withdrawals are much more likely to have more severe withdrawal subsequently, and probably not respond as well to medication to block the withdrawal symptoms," said Robert Malcolm, professor of psychiatry, family medicine and pediatrics, and clinical investigator at the Center for Drug and Alcohol Programs, Medical University of South Carolina. "This study squarely points out the relevance of multiple withdrawals by demonstrating some alterations in neurocognitive functioning in this group of people."

Study authors examined 85 volunteers divided into two groups: 42 abstinent alcoholics (24 males, 18 females) in inpatient treatment, and 43 social drinkers (23 males, 20 females) recruited from a university setting. The patient population was further divided into two populations based on information about prior, medically supervised detoxifications: patients with fewer than two experiences (n=36) and patients with two or more experiences (n=6).

All of the subjects were asked to complete four types of tasks designed to measure executive function, which is responsible for supervising the production and execution of responses based on demands from the environment. The four tasks included a maze, which measured the ability to follow goals; a color-naming task; a vigilance task, which measured the ability to pay attention and disinhibit a pre-potent response; and a delay task, which measured the ability to wait before a response in order to receive a reward.

Results indicate that repeated withdrawals from alcohol are associated with increased impairment of cognitive function, specifically, frontal-lobe damage.

"The frontal lobes are extremely important for inhibiting behaviors," said Malcolm, "and are also important for tasks that require attention."

Part Two: Test Results

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