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After Years of Sobriety, Alcoholics' Brains Near Normal Function


CORTE MADERA, Calif. -- If alcoholics quit drinking early enough and stay sober long enough, the recovery of their mental functions will be nearly complete, a study here suggested.

CORTE MADERA, Calif., Aug. 28 -- If alcoholics quit drinking early enough and stay sober long enough, the recovery of their mental functions will be nearly complete, a study here suggested.

A group of 48 alcoholics who had remained sober for an average of nearly seven years (and some as long as 13 years), performed essentially the same on an extensive battery of neurocognitive tests as a group of healthy controls, George Fein, Ph.D., and colleagues reported in the September issue of Alcoholism: Clinical & Experimental Research.

Previous studies have shown that the brain bounces back substantially over the first month to year of sobriety, but few studies have assessed mental function after years of abstinence, said Dr, Fein, formerly of the University of California San Francisco, is now with the company Neurobehavioral Research.

"We found pretty much full recovery," Dr. Fein said in an interview. "We weren't expecting that."

The one exception was in spatial processing, where deficits have often been reported in alcoholics, the investigators said. Daily life tasks involving spatial processing include reading a map or following the instructions for assembling a child's toy, Dr. Fein said.

The former alcoholics performed significantly worse in spatial processing compared with controls. For example, the male former drinkers' scores placed them in about the 55th percentile of a nationally representative sample, while their control counterparts were in the 66th percentile (P=.05).

The study included 25 men and 23 women. Their average age was about 47. Their performance was measured in nine neurocognitive domains believed to be affected by alcoholism: abstraction/cognitive flexibility, attention, auditory working memory, immediate memory, delayed memory, psychomotor function, reaction time, spatial processing, and verbal skills.

Performance in eight of these was "essentially equivalent" to an age-matched group of non-alcoholic controls, the researchers said.

Both groups probably did better than the national average because of the relatively high socioeconomic status of the San Francisco Bay area participants, the investigators noted.

"We offer the finding of spatial processing deficits in long term abstinent alcoholics versus normal controls with caution," the investigators said.

"First, there were no statistically significant group differences on any of the three tests within the spatial processing domain; only when the three tests were averaged together was there a statistically significant difference between groups," they said. Second, spatial processing was one of nine neuropsychological domains tested, without correction for multiple comparisons."

"Therefore, there is no strong statistical evidence for the spatial processing deficit," they cautioned.

"Nevertheless, spatial processing deficits are among the impairments most often reported in abstinent alcoholic individuals, and other investigators also report that this specific deficit may not resolve, even with long-term sobriety," they added.

In the end, "This study reinforces the generally held view that spatial processing function may be particularly vulnerable to impairment in alcoholic individuals and especially resistant to full recovery with long-term abstinence," they concluded.

A chief limitation of the study was that it lacked neurocognitive data on the alcoholics while they were drinking. Therefore, it could not determine the extent of cognitive deficit in this group before it stopped drinking or make a direct before-and-after comparison, the investigators said.

Another caveat is that the abstinent alcoholics in this study had all stopped drinking before the age of 50, Dr. Fein said, "so we don't know if the results would be the same for people who stopped drinking at age 60 or 70."

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