Neuropsychiatry of alcohol-related brain damage

Korsakoff’S Syndrome ◽

Clinical Phase ◽

Korsakoff's Syndrome ◽

Neurocognitive Dysfunctions ◽

Like the liver, the brain is commonly affected by long-term alcohol misuse. While neurocognitive dysfunctions are widely known in their most extreme presentations, such as Korsakoff’s syndrome and Wernicke’s encephalopathy (WE), there are other less explicit manifestations of neurocognitive damage which occur more frequently. This chapter explores these conditions under the umbrella term ‘alcohol-related brain damage’ (ARBD), more specifically employing the term Wernicke–Korsakoff’s syndrome (WK) when referring to the acute and chronic effects of thiamine deficiency. The correlation between excessive alcohol consumption and thiamine intake is explored, along with the body’s response of boosting gamma-aminobutyric acid (GABA)–benzodiazepine and NMDA receptors. In acute and non-acute cases of ARBD, prompt diagnosis and treatment are essential due to the risk of long-term cognitive and intellectual damage it can yield. As such, psychosocial treatment in the aftermath of the clinical phase is equally important, focusing on assessment, therapeutic intervention, adjustment, and social integration.

Excessive alcohol consumption after liver transplantation impacts on long-term survival, whatever the primary indication

Journal of Hepatology ◽

10.1016/j.jhep.2012.03.014 ◽

2012 ◽

Vol 57 (2) ◽

pp. 306-312 ◽

Cited By ~ 74

Author(s):

Stéphanie Faure ◽

Astrid Herrero ◽

Boris Jung ◽

Yohan Duny ◽

Jean-Pierre Daures ◽

...

Keyword(s):

Liver Transplantation ◽

Alcohol Consumption ◽

Term Survival ◽

Long Term Survival ◽

Primary Indication ◽

Alcohol-Related Dementia: Rethink How Much You Drink

The Senior Care Pharmacist ◽

10.4140/tcp.n.2021.324. ◽

2021 ◽

Vol 36 (7) ◽

pp. 324-330

Author(s):

Raquel Mateus ◽

Jeannette Y. Wick

Keyword(s):

Alcohol Consumption ◽

Heavy Drinking ◽

Care Plans ◽

Korsakoff Syndrome ◽

Excessive Alcohol ◽

The 1960S ◽

Heath Care ◽

Abstinence From Alcohol

People have consumed alcohol for centuries. Most clinicians who work with people who have dementia acknowledge that alcohol may cause or exacerbate dementia's symptoms. Alcohol-related dementia (ARD) has been recognized since the 1960s, but clinicians rarely use this diagnosis. Regardless, it is common and develops pursuant to long-term excessive alcohol consumption. It may, in some cases, evolve into Wernicke-Korsakoff syndrome. Diagnosis can be obscured if patients are not truthful about their alcohol consumption. Often, friends or family provide a better picture of the patient's alcohol history than patients do themselves. Thiamine treatment may prevent or improve symptoms. Abstinence from alcohol is critical, but it is difficult for older people with long histories of heavy drinking. Consultant pharmacists can help the heath care team develop nuanced care plans for patients who have ARD.

Mental well-being in subjects with long-term excessive alcohol consumption

Alcohol ◽

10.1016/s0741-8329(02)00218-5 ◽

2002 ◽

Vol 27 (2) ◽

pp. 99-105

Author(s):

Matts Eriksson ◽

Ulf Berggren ◽

Claudia Fahlke ◽

Ernest Hård ◽

Jan Balldin

Keyword(s):

Alcohol Consumption ◽

Well Being ◽

Excessive Alcohol ◽

Mental Well Being

511 THE IMPACT OF MODERATE AND EXCESSIVE ALCOHOL CONSUMPTION ON THE LONG-TERM OUTCOMES OF PATIENTS WITH CHRONIC HEPATITIS C (CH-C)

Journal of Hepatology ◽

10.1016/s0168-8278(13)60513-9 ◽

2013 ◽

Vol 58 ◽

pp. S210

Author(s):

Z.M. Younossi ◽

L. Zheng ◽

M. Stepanova ◽

C. Venkatesan ◽

H.M. Mir

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Alcohol Consumption ◽

Chronic Hepatitis C ◽

Long Term Outcomes ◽

Excessive Alcohol ◽

The Impact

Long-term behavioural rewriting of maladaptive drinking memories via reconsolidation-update mechanisms

Psychological Medicine ◽

10.1017/s0033291720001531 ◽

2020 ◽

pp. 1-11

Author(s):

Grace Gale ◽

Katie Walsh ◽

Vanessa E. Hennessy ◽

L. E. Stemerding ◽

Koa Sher Ni ◽

...

Keyword(s):

Alcohol Consumption ◽

Individual Variability ◽

Therapeutic Window ◽

Large Variability ◽

Behavioural Interventions ◽

Problematic Drinking ◽

Acute Responses ◽

Abstract Background Alcohol use disorders can be conceptualised as a learned pattern of maladaptive alcohol-consumption behaviours. The memories encoding these behaviours centrally contribute to long-term excessive alcohol consumption and are therefore an important therapeutic target. The transient period of memory instability sparked during memory reconsolidation offers a therapeutic window to directly rewrite these memories using targeted behavioural interventions. However, clinically-relevant demonstrations of the efficacy of this approach are few. We examined key retrieval parameters for destabilising naturalistic drinking memories and the ability of subsequent counterconditioning to effect long-term reductions in drinking. Methods Hazardous/harmful beer-drinking volunteers (N = 120) were factorially randomised to retrieve (RET) or not retrieve (No RET) alcohol reward memories with (PE) or without (No PE) alcohol reward prediction error. All participants subsequently underwent disgust-based counterconditioning of drinking cues. Acute responses to alcohol were assessed pre- and post-manipulation and drinking levels were assessed up to 9 months. Results Greater long-term reductions in drinking were found when counterconditioning was conducted following retrieval (with and without PE), despite a lack of short-term group differences in motivational responding to acute alcohol. Large variability in acute levels of learning during counterconditioning was noted. ‘Responsiveness’ to counterconditioning predicted subsequent responses to acute alcohol in RET + PE only, consistent with reconsolidation-update mechanisms. Conclusions The longevity of behavioural interventions designed to reduce problematic drinking levels may be enhanced by leveraging reconsolidation-update mechanisms to rewrite maladaptive memory. However, inter-individual variability in levels of corrective learning is likely to determine the efficacy of reconsolidation-updating interventions and should be considered when designing and assessing interventions.

Long-term Behavioural Rewriting of Maladaptive Drinking Memories via Reconsolidation-Update Mechanisms

10.1101/2020.02.06.937698 ◽

2020 ◽

Author(s):

Grace. Gale ◽

Vanessa E. Hennessy ◽

Katie. Walsh ◽

Sunjeev K. Kamboj ◽

Ravi. K. Das

Keyword(s):

Alcohol Consumption ◽

Individual Variability ◽

Therapeutic Window ◽

Large Variability ◽

Behavioural Interventions ◽

Problematic Drinking ◽

Acute Responses ◽

ABSTRACTBackgroundAlcohol use disorders can be conceptualised as a learned pattern of maladaptive alcohol-consumption behaviours. The memories encoding these behaviours centrally contribute to long-term excessive alcohol consumption and are a key therapeutic target. The transient period of memory instability sparked during memory reconsolidation offers a therapeutic window to directly rewrite these memories using targeted behavioural interventions. However, clinically-relevant demonstrations of the efficacy of this approach are few. We examined key retrieval parameters for destabilising naturalistic drinking memories and the ability of subsequent counterconditioning to effect long-term reductions in drinking.MethodsHazardous/harmful beer-drinking volunteers (N=120) were factorially randomised to retrieve (RET) or not retrieve (No RET) alcohol reward memories with (PE) or without (No PE) alcohol reward prediction error. All participants subsequently underwent disgust-based counterconditioning of drinking cues. Acute responses to alcohol were assessed pre- and post-manipulation and drinking levels assessed up to 9 months.ResultsGreater long-term reductions in drinking were found when counterconditioning was conducted following retrieval (with and without PE), despite a lack of short-term group differences in motivational responding to acute alcohol. Large variability in acute levels of learning during counterconditioning were noted. ‘Responsiveness’ to counterconditioning predicted subsequent responses to acute alcohol in RET+PE only, consistent with reconsolidation-update mechanisms.ConclusionsThe longevity of behavioural interventions designed to reduce problematic drinking levels may be enhanced by leveraging reconsolidation-update mechanisms to rewrite maladaptive memory. However, inter-individual variability in levels of corrective learning is likely to determine the efficacy of reconsolidation-updating interventions and should be considered when designing and assessing interventions.

COVID-19 pandemic and alcohol: a problem beyond addiction and psychiatry

Clinical review for general practice ◽

10.47407/kr2020.1.2.00012 ◽

2020 ◽

Vol 1 (2) ◽

pp. 11-15

Author(s):

Yury P. Sivolap ◽

Keyword(s):

Alcohol Use ◽

Alcohol Abuse ◽

Global Health ◽

Significant Deterioration ◽

Susceptibility To Infection ◽

Number Of Patients ◽

Special Programs ◽

The increase in alcohol use during the COVID-19 pandemic is one of the major global health problems. Alcohol abuse is caused by many causes, including the stress associated with the pandemic. The problem of alcohol abuse is getting worse by the difficult access of patients to medical care, and lockdown, including a restrained sale of alcohol, can lead to numerous cases of severe alcohol withdrawal, alcohol psychosis and suicide. Excessive alcohol consumption reduces the immune system, increases susceptibility to infection, including SARS-CoV-2, and contributes to the severe course of COVID-19, increasing the likelihood of complications and death. It is assumed that alcohol abuse during the pandemic will have long-term adverse consequences in the form of significant deterioration of public health, an increase in the number of patients with alcohol dependence and alcoholic liver disease, and an excessive burden on global health. Experts justify the need to apply special programs to help people with alcohol use disorders during the pandemic and develop a set of preventive measures to prevent the adverse long-term consequences of excessive alcohol use.

Alcohol-Related Dementia: Rethink How Much You Drink

The Senior Care Pharmacist ◽

10.4140/tcp.n.2021.324 ◽

2021 ◽

Vol 36 (7) ◽

pp. 324-330

Author(s):

Raquel Mateus ◽

Jeannette Y. Wick

Keyword(s):

Alcohol Consumption ◽

Heavy Drinking ◽

Care Plans ◽

Korsakoff Syndrome ◽

Excessive Alcohol ◽

The 1960S ◽

Heath Care ◽

Abstinence From Alcohol

People have consumed alcohol for centuries. Most clinicians who work with people who have dementia acknowledge that alcohol may cause or exacerbate dementia’s symptoms. Alcohol-related dementia (ARD) has been recognized since the 1960s, but clinicians rarely use this diagnosis. Regardless, it is common and develops pursuant to long-term excessive alcohol consumption. It may, in some cases, evolve into Wernicke-Korsakoff syndrome. Diagnosis can be obscured if patients are not truthful about their alcohol consumption. Often, friends or family provide a better picture of the patient’s alcohol history than patients do themselves. Thiamine treatment may prevent or improve symptoms. Abstinence from alcohol is critical, but it is difficult for older people with long histories of heavy drinking. Consultant pharmacists can help the heath care team develop nuanced care plans for patients who have ARD.

The effect of errorless learning on psychotic and affective symptoms, as well as aggression and apathy in patients with Korsakoff's syndrome in long-term care facilities

International Psychogeriatrics ◽

10.1017/s1041610218000492 ◽

2018 ◽

Vol 31 (1) ◽

pp. 39-47 ◽

Cited By ~ 3

Author(s):

Yvonne C. M. Rensen ◽

Jos I. M. Egger ◽

Josette Westhoff ◽

Serge J. W. Walvoort ◽

Roy P.C. Kessels

Keyword(s):

Long Term Care ◽

Control Group ◽

Errorless Learning ◽

Term Care ◽

Korsakoff’S Syndrome ◽

Affective Symptoms ◽

Care Facilities ◽

Korsakoff's Syndrome ◽

Psychiatric Problems

ABSTRACTObjectives:Errorless learning is a promising rehabilitation principle for learning tasks in patients with amnesia, including patients with Korsakoff's syndrome. Errorless learning might possibly also contribute to decreases in behavioral and psychiatric problems, as patients in long-term care facilities become more independent after training. The aim of this study was to examine the effects of errorless learning on potential changes in psychotic and affective symptoms, aggression and apathy, in contrast with a control group who received care as usual.Methods:The current study is a quasi-experimental study on errorless learning and psychotic and affective symptoms, aggression, and apathy in patients with Korsakoff's syndrome, living in long-term care facilities for patients with Korsakoff's syndrome (KS) in the Netherlands. The GIP-28, HoNOS−ABI, and NVCL−20 were administered to a group of patients with KS who received errorless learning training (n= 51) and a patient control group who received care as usual (n= 31). Wilcoxon Signed-Rank Tests were performed to examine psychotic and affective symptoms, aggression, and apathy at baseline and at follow-up in the errorless learning group and the control group.Results:Errorless learning training effectively reduced psychotic symptoms (including provoked confabulations), affective symptoms, and agitation/aggression. There were no significant changes (increases nor decreases) in the control group. Levels of apathy were stable over time in both groups.Conclusions:Results with respect to psychotic and affective symptoms, aggression, and apathy are discussed in depth. Patients with KS can become more autonomous in a cared for setting using errorless learning principles. This might also result in decreases in behavioral and psychiatric problems in patients.