, 2003). Frontal-executive functions are known to include the ability to plan ahead and to overcome impulsive behaviour. It would therefore follow that frontal-executive impairments would correlate with the occurrence of relapses. Unfortunately, no studies to date have provided convincing data to support this proposal (Bowden, Crews, Bates, Fals-Stewart, & Ambrose, 2001). A recent study by Loeber et al. (2010) demonstrated a negative effect on cognitive function and recovery in 31 patients. However, they did not show a correlation with the occurrence of relapses, and included participants with a relatively positive prognosis. In contrast, the study presented here examined

only patients with a history of being resistant to therapy, who can therefore be assumed to have a negative prognosis. Our study thus provides preliminary support for a negative check details association between frontal-executive deficits and future prognosis, although

further longitudinal data and replication with larger cohorts selleck products are required. A clinical implication may be drawn from these results based on data indicating that cognitive deficits tend to improve with abstinence (Fals-Stewart & Lam, 2010). It may hence be assumed that patients with subtle executive deficits may benefit most from long-term therapeutic options rather than from frequent detoxifications. It is also noteworthy that the cognitive deficits manifested solely in more dedicated neuropsychological tests (TMT and RWT), and would therefore probably have been missed by routine clinical tests. Similarly, while patients did not fulfil the ICD10 criteria for depressive syndrome, they reported significantly more depressive features MCE公司 in the BDI questionnaire

compared with controls. These depressive tendencies may have aggravated executive impairments, but also would not have been detected in routine clinical tests. In summary, the study presented here found that severely alcohol-dependent subjects who have experienced recurrent withdrawals display subtle cognitive deficits. These deficits occurred primarily in the frontal-executive domain, while memory functions and visuospatial capacities were largely spared. Our pilot study therefore suggests that extensive cognitive testing might be a helpful additional tool in assessing therapy-resistant heavy drinkers. Future trials will elucidate the influence these cognitive deficits have on prognosis and quality of life. “
“Impulse control disorders (ICDs) and apathy are recognized as two important neuropsychiatric syndromes associated with Parkinson’s disease (PD), but as yet we understand very little about the cognitive mechanisms underlying them. Here, we review emerging findings, from both human and animal studies, that suggest that impulsivity and apathy are opposite extremes of a dopamine-dependent spectrum of motivated decision making.