Impairment in cognitive function following multiple detoxifications in alcoholic inpatients

Background: Repeated experience of withdrawal from alcohol results in a kindling-like process leading to increased likelihood and severity of convulsions during detoxification. The aim of this study was to determine whether repeated withdrawals affect cognitive function. Methods: We investigated alcoholic patients undergoing detoxification in an inpatient setting, using tasks sensitive to dysfunction of prefrontal areas. The tasks applied were two maze tasks from the Wechsler Intelligence Scale for Children, the color Stroop task, and the vigilance task for adults and the delay task from the Gordon Diagnostic System. Forty-two abstinent alcoholic patients who were no longer receiving pharmacotherapy for detoxification participated. Results: Compared to a group of forty-three social drinkers matched for age, sex, and verbal IQ, the alcoholic patients took more time to complete maze 1 and made more errors in both mazes. Alcoholics made more commission errors and gave fewer correct answers in the vigilance task. No differences were found in the color Stroop task between alcoholic patients and social drinkers. Patients with 2 or more detoxifications were more impaired in the maze 1, in the vigilance task and in the delay task than patients with a single, or no previous detoxification. When patients were reclassified on the basis of the total number of attempts at withdrawing from alcohol (including the medically supervised) only the deficit in the vigilance task was associated with the number of withdrawal attempts. The effects of medically supervised detoxifications on maze 1 and vigilance task were confounded with other factors related to the history of alcoholism, alcohol use, age of starting heavy drinking and years of problem drinking. Conclusions: Repeated experience of withdrawal from alcohol is thus associated with impaired cognitive function although it appears that for some of these effects, other factors associated with the history of alcoholism might also be involved.