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Wiener Medizinische Wochenschrift
Erschienen in: Wiener Medizinische Wochenschrift 1-2/2014

01.01.2014 | themenschwerpunkt

Alkohol induzierte kognitive Dysfunktion

verfasst von: Elisabeth Weiss, Evelin M. Singewald, PhD, Beatrix Ruepp, Josef Marksteiner

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 1-2/2014

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Zusammenfassung

Alkoholkonsum kann zu einer akuten Intoxikation mit entsprechender klinischer Symptomatik führen. Im ersten Stadium der Alkoholintoxikation kommt es zur Exzitation mit Enthemmungen, verlängerten Reaktionszeiten und verminderter Schmerzwahrnehmung, sowie zu nachweisbaren Veränderungen der kognitiven Leistungen insbesondere zu einer Beeinträchtigung der Gedächtnisleistungen. Jedoch sind die kognitiven Folgen einer Intoxikation in den allermeisten Fällen reversibel sofern keine Alkoholabhängigkeit besteht. Durch chronischen Alkoholkonsum ergeben sich erhebliche neuropsychologische Defizite. Insbesondere zeigen Alkoholkranke eine deutliche Dysfunktionalität in der sozialen Kognition sowie Defizite in exekutiven Funktionen wie in Problemlösefähigkeiten und Abstraktion, beim Entscheidungstreffen, Planen und Organisieren aber auch Beeinträchtigung der Handlungskontrolle und Inhibierung.
Bei etwa 50 % der Alkoholabhängigen sind Einbußen der Kognition mit einer zerebralen Atrophie in der Bildgebung des Gehirns vergesellschaftet. Es zeigen sich auch geschlechtsspezifische Unterschiede, sowohl auf akute Alkoholintoxikation, als auch bei chronischem Alkoholkonsum reagieren Frauen vulnerabler mit Entwicklung dauerhafter Schäden.
Vorheriger Artikel Management bei schwerer alkoholischer Hepatitis
Nächster Artikel Alcohol and bone
Literatur
1.
Seiferth B. Neurobiologie der Sucht und Brain Imaging. Spectrum Psychiatr. 2012; 12:11–3.
2.
Bartsch AJ, Homola G, Biller A, Smith SM, Weijers HG, Wiesbeck GA, Jenkinson M, De Stefano N, Solymosi L, Bendszus M. Manifestations of early brain recovery associated with abstinence from alcoholism. Brain J Neurol. 2007; 130(Pt 1):36–47.CrossRef
3.
Weissenborn R, Duka T. Acute alcohol effects on cognitive function in social drinkers: their relationship to drinking habits. Psychopharmacology. 2003; 165(3):306–12.PubMed
4.
Mitchell IJ, Beck SR, Boyal A, Edwards VR. Theory of mind deficits following acute alcohol intoxication. Eur Addict Res. 2011; 17(3):164–8.PubMedCrossRef
5.
Acheson SK, Stein RM, Swartzwelder HS. Impairment of semantic and figural memory by acute ethanol: age-dependent effects. Alcohol Clin Exp Res. 1998; 22(7):1437–42.PubMedCrossRef
6.
Schummers J, Browning MD. Evidence for a role for GABA(A) and NMDA receptors in ethanol inhibition of long-term potentiation. Brain Res Mol Brain Res. 2001; 94(1–2):9–14.PubMedCrossRef
7.
Schummers J, Bentz S, Browning MD. Ethanol’s inhibition of LTP may not be mediated solely via direct effects on the NMDA receptor. Alcohol Clin Exp Res. 1997; 21(3):404–8.PubMedCrossRef
8.
9.
Schweizer TA, Vogel-Sprott M, Danckert J, Roy EA, Skakum A, Broderick CE. Neuropsychological profile of acute alcohol intoxication during ascending and descending blood alcohol concentrations. Neuropsychopharmacology. 2006; 31(6):1301–9.PubMed
10.
Wakita M, Shin MC, Iwata S, Nonaka K, Akaike N. Effects of ethanol on GABA(A) receptors in GABAergic and glutamatergic presynaptic nerve terminals. J Pharmacol Exp Ther. 2012; 341(3):809–19.PubMedCrossRef
11.
Soderpalm B, Ericson M. Neurocircuitry involved in the development of alcohol addiction: the dopamine system and its access points. Curr Top Behav Neurosci. 2013; 13:127–61.PubMedCrossRef
12.
Guerrini I, Thomson AD, Gurling HD. The importance of alcohol misuse, malnutrition and genetic susceptibility on brain growth and plasticity. Neurosci Biobehav Rev. 2007; 31(2):212–20.PubMedCrossRef
13.
Thomson AD, Pratt OE, Jeyasingham M, Shaw GK. Alcohol and brain damage. Hum Toxicol. 1988; 7(5):455–63.PubMedCrossRef
14.
Phillips SC, Harper CG, Kril J. A quantitative histological study of the cerebellar vermis in alcoholic patients. Brain J Neurol. 1987; 110 (Pt 2):301–14.CrossRef
15.
Zahr NM, Pitel AL, Chanraud S, Sullivan EV. Contributions of studies on alcohol use disorders to understanding cerebellar function. Neuropsychol Rev. 2010; 20(3):280–9.PubMedCentralPubMedCrossRef
16.
Komarekova I, Janik M. Effects of alcohol on the brain biomembranes: a review. Soud Lek. 2012; 57(4):75–7.PubMed
17.
Ollat H, Parvez H, Parvez S. Alcohol and central neurotransmission. Neurochem Int. 1988; 13(3):275–300.PubMedCrossRef
18.
Rottenberg H, Waring A, Rubin E. The molecular basis of alcohol tolerance and drug cross-tolerance in chronic alcoholism. Biophys J. 1982; 37(1):14–6.PubMedCentralPubMedCrossRef
19.
Kumar S, Porcu P, Werner DF, Matthews DB, Diaz-Granados JL, Helfand RS, Morrow AL. The role of GABA(A) receptors in the acute and chronic effects of ethanol: a decade of progress. Psychopharmacology. 2009; 205(4):529–64.PubMedCentralPubMedCrossRef
20.
Deik A, Saunders-Pullman R, San Luciano M. Substance abuse and movement disorders: complex interactions and comorbidities. Curr Drug Abus Rev. 2012 Sep; 5(3):243–53.
21.
Carlen PL, Lee MA, Jacob M, Livshits O. Parkinsonism provoked by alcoholism. Ann Neurol. 1981; 9(1):84–6.PubMedCrossRef
22.
Hawley RJ, Major LF, Schulman EA, Linnoila M. Cerebrospinal fluid 3-methoxy-4-hydroxyphenylglycol and norepinephrine levels in alcohol withdrawal. Correlations with clinical signs. Arch Gen Psychiatry. 1985; 42(11):1056–62.PubMedCrossRef
23.
Oscar-Berman M, Shagrin B, Evert DL, Epstein C. Impairments of brain and behavior: the neurological effects of alcohol. Alcohol Health Res World. 1997; 21(1):65–75.PubMed
24.
Parsons OA. Neurocognitive deficits in alcoholics and social drinkers: a continuum? Alcohol Clin Exp Res. 1998; 22(4):954–61.PubMed
25.
Ramchandani VA, Bosron WF, Li TK. Research advances in ethanol metabolism. Pathol Biol. 2001; 49(9):676–82.PubMedCrossRef
26.
Ceylan-Isik AF, McBride SM, Ren J. Sex difference in alcoholism: who is at a greater risk for development of alcoholic complication? Life Sci. 2010; 87(5–6):133–8.PubMedCentralPubMedCrossRef
27.
Nolen-Hoeksema S. Gender differences in risk factors and consequences for alcohol use and problems. Clin Psychol Rev. 2004; 24(8):981–1010.PubMedCrossRef
28.
McGuire LC, Ajani UA, Ford ES. Cognitive functioning in late life: the impact of moderate alcohol consumption. Ann Epidemiol. 2007; 17(2):93–9.PubMedCrossRef
29.
Yonker JE, Nilsson LG, Herlitz A, Anthenelli RM. Sex differences in spatial visualization and episodic memory as a function of alcohol consumption. Alcohol Alcohol. 2005; 40(3):201–7.PubMedCrossRef
30.
Hommer DW. Male and female sensitivity to alcohol-induced brain damage. Alcohol Res Health. 2003; 27(2):181–5.PubMed
31.
Prendergast MA. Do women possess a unique susceptibility to the neurotoxic effects of alcohol? J Am Med Womens Assoc. 2004; 59(3):225–7.PubMed
32.
Lyu J, Lee SH. Gender differences in the link between excessive drinking and domain-specific cognitive functioning among older adults. J Aging Health. 2012; 24(8):1380–98.PubMedCrossRef
33.
Walter H, Gutierrez K, Ramskogler K, Hertling I, Dvorak A, Lesch OM. Gender-specific differences in alcoholism: implications for treatment. Arch Women’s Ment Health 2003; 6(4):253–8.CrossRef
34.
Moselhy HF, Georgiou G, Kahn A. Frontal lobe changes in alcoholism: a review of the literature. Alcohol Alcohol. 2001; 36(5):357–68.PubMedCrossRef
35.
Moriyama Y, Mimura M, Kato M, Yoshino A, Hara T, Kashima H, Kato A, Watanabe A. Executive dysfunction and clinical outcome in chronic alcoholics. Alcohol Clin Exp Res. 2002; 26(8):1239–44.PubMedCrossRef
36.
Sullivan EV, Rosenbloom MJ, Pfefferbaum A. Pattern of motor and cognitive deficits in detoxified alcoholic men. Alcohol Clin Exp Res. 2000; 24(5):611–21.PubMedCrossRef
37.
Bechara A, Dolan S, Denburg N, Hindes A, Anderson SW, Nathan PE. Decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in alcohol and stimulant abusers. Neuropsychologia. 2001; 39(4):376–89.PubMedCrossRef
38.
Holmes A, Fitzgerald PJ, MacPherson KP, DeBrouse L, Colacicco G, Flynn SM, Masneuf S, Pleil KE, Li C, Marcinkiewcz CA et al. Chronic alcohol remodels prefrontal neurons and disrupts NMDAR-mediated fear extinction encoding. Nat Neurosci. 2012; 15(10):1359–61.PubMedCentralPubMedCrossRef
39.
Hildebrandt H, Brokate B, Eling P, Lanz M. Response shifting and inhibition, but not working memory, are impaired after long-term heavy alcohol consumption. Neuropsychology. 2004; 18(2):203–11.PubMedCrossRef
40.
41.
Bechara A, Tranel D, Damasio H. Characterization of the decision-making deficit of patients with ventromedial prefrontal cortex lesions. Brain J Neurol. 2000; 123 (Pt 11):2189–202.CrossRef
42.
Wollenweber FA, Halfter S, Brugmann E, Weinberg C, Cieslik EC, Muller VI, Hardwick RM, Eickhoff SB. Subtle cognitive deficits in severe alcohol addicts – Do they show a specific profile? J Neuropsychol. 2012 Oct 29. doi: 10.1111/jnp.12001. [Epub ahead of print].
43.
Desmond JE, Chen SH, DeRosa E, Pryor MR, Pfefferbaum A, Sullivan EV. Increased frontocerebellar activation in alcoholics during verbal working memory: an fMRI study. NeuroImage. 2003; 19(4):1510–20.PubMedCrossRef
44.
De Rosa E, Desmond JE, Anderson AK, Pfefferbaum A, Sullivan EV. The human basal forebrain integrates the old and the new. Neuron. 2004; 41(5):825–37.PubMedCrossRef
45.
Schulte T, Oberlin BG, Kareken DA, Marinkovic K, Muller-Oehring EM, Meyerhoff DJ, Tapert S. How Acute and Chronic Alcohol Consumption Affects Brain Networks: Insights into Multimodal Neuroimaging. Alcohol Clin Exp Res. 2012; 36:2017–27.PubMedCrossRef
46.
Kircher T, Leube D, Habel U. [Functional magnetic resonance tomography in patients with schizophrenia: neural correlates of symptoms, cognition and emotion]. Nervenarzt. 2009; 80(9):1103–16.PubMedCrossRef
47.
Marinkovic K, Rickenbacher E, Azma S, Artsy E. Acute alcohol intoxication impairs top-down regulation of Stroop incongruity as revealed by blood oxygen level-dependent functional magnetic resonance imaging. Hum Brain Mapp. 2012; 33(2):319–33.PubMedCentralPubMedCrossRef
48.
Pfefferbaum A, Desmond JE, Galloway C, Menon V, Glover GH, Sullivan EV. Reorganization of frontal systems used by alcoholics for spatial working memory: an fMRI study. NeuroImage. 2001; 14(1 Pt 1):7–20.PubMedCrossRef
49.
Tapert SF, Schweinsburg AD, Barlett VC, Brown SA, Frank LR, Brown GG, Meloy MJ. Blood oxygen level dependent response and spatial working memory in adolescents with alcohol use disorders. Alcohol Clin Exp Res. 2004, 28(10):1577–86.PubMedCrossRef
50.
Parks MH, Greenberg DS, Nickel MK, Dietrich MS, Rogers BP, Martin PR. Recruitment of additional brain regions to accomplish simple motor tasks in chronic alcohol-dependent patients. Alcohol Clin Exp Res. 2010 Jun; 34(6):1098–109.
51.
Uekermann J, Daum I, Schlebusch P, Trenckmann U. Processing of affective stimuli in alcoholism. Cortex. 2005; 41(2):189–94.PubMedCrossRef
52.
Gallagher HL, Frith CD. Functional imaging of ‘theory of mind’. Trends Cogn Sci. 2003; 7(2):77–83.PubMedCrossRef
53.
Gallagher HL, Happe F, Brunswick N, Fletcher PC, Frith U, Frith CD. Reading the mind in cartoons and stories: an fMRI study of ‘theory of mind’ in verbal and nonverbal tasks. Neuropsychologia. 2000; 38(1):11–21.PubMedCrossRef
54.
Goel V, Dolan RJ. The functional anatomy of humor: segregating cognitive and affective components. Nat Neurosci. 2001; 4(3):237–8.PubMedCrossRef
55.
Uekermann J, Channon S, Winkel K, Schlebusch P, Daum I. Theory of mind, humour processing and executive functioning in alcoholism. Addiction. 2007; 102(2):232–40.PubMedCrossRef
56.
Ellis RJ, Oscar-Berman M. Alcoholism, aging, and functional cerebral asymmetries. Psychol Bull. 1989; 106(1):128–47.PubMedCrossRef
57.
Ryan C, Butters N. Alcohol consumption and premature aging. A critical review. Recent Dev Alcohol. 1984; 2:223–50.PubMed
58.
Sullivan EV, Fama R, Rosenbloom MJ, Pfefferbaum A. A profile of neuropsychological deficits in alcoholic women. Neuropsychology. 2002; 16(1):74–83.PubMedCrossRef
Metadaten
Titel
Alkohol induzierte kognitive Dysfunktion
verfasst von
Elisabeth Weiss
Evelin M. Singewald, PhD
Beatrix Ruepp
Josef Marksteiner
Publikationsdatum
01.01.2014
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 1-2/2014
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-013-0226-0

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