Recovery of neurocognitive functions following sustained abstinence after substance dependence and implications for treatment.

BACKGROUND Substance Use Disorders (SUDs) have been associated with impaired neurocognitive functioning, which may (partly) improve with sustained abstinence. New treatments are emerging, aimed at improving cognitive functions, and being tested. However, no integrated review is available regarding neurocognitive recovery following sustained abstinence. OBJECTIVES In this review, results from prospective studies on neurocognitive recovery using neuropsychological assessments before and after sustained abstinence from SUDs are summarized and discussed. RESULTS Thirty-five prospective studies were selected for this review, including twenty-two alcohol, three cannabis, four cocaine, three (meth)amphetamine, and three opioid studies. Results suggest that some cognitive functions (partially) recover after sustained abstinence, and that there are predictors of an unfavorable course such as poly-substance use and number of previous detoxifications. CONCLUSIONS Prospective studies indicate that sustained abstinence after SUDs generally results in (partial) neurocognitive recovery. However, a final answer regarding full recovery awaits prospective studies with neurocognitive assessments before, during, and after sustained abstinence from SUDs. New interventions that might enhance neurocognitive recovery after abstinence are discussed, including neurocognitive training, medication and neuromodulation.

[1]  L. Merabet,et al.  Prefrontal cortex modulation using transcranial DC stimulation reduces alcohol craving: a double-blind, sham-controlled study. , 2008, Drug and alcohol dependence.

[2]  R. Stickgold,et al.  Cocaine Users Differ from Normals on Cognitive Tasks Which Show Poorer Performance During Drug Abstinence , 2008, The American journal of drug and alcohol abuse.

[3]  Paul F. Hill,et al.  Remember the Future: Working Memory Training Decreases Delay Discounting Among Stimulant Addicts , 2011, Biological Psychiatry.

[4]  Colin Studholme,et al.  Deformation-based morphometry of brain changes in alcohol dependence and abstinence , 2007, NeuroImage.

[5]  P. Philippot,et al.  Impaired emotional facial expression recognition in alcohol dependence: do these deficits persist with midterm abstinence? , 2007, Alcoholism, clinical and experimental research.

[6]  P. Allebeck,et al.  Marijuana use and risk of lung cancer: a 40-year cohort study , 2013, Cancer Causes & Control.

[7]  M. Ghoneim,et al.  Chronic drug use and cognitive impairments , 2002, Pharmacology Biochemistry and Behavior.

[8]  N. Volkow,et al.  Drugs and alcohol: treating and preventing abuse, addiction and their medical consequences. , 2005, Pharmacology & therapeutics.

[9]  G. Gigerenzer,et al.  Specific attentional dysfunction in adults following early start of cannabis use , 1999, Psychopharmacology.

[10]  A. Waters,et al.  Cognitive enhancement as a treatment for drug addictions , 2013, Neuropharmacology.

[11]  A. Miyake,et al.  Individual differences in executive functions are almost entirely genetic in origin. , 2008, Journal of experimental psychology. General.

[12]  F. Crews,et al.  Associations between heavy drinking and changes in impulsive behavior among adolescent boys. , 2011, Alcoholism, clinical and experimental research.

[13]  Jerry L. Grenard,et al.  Automatic and controlled processes and the development of addictive behaviors in adolescents: A review and a model , 2007, Pharmacology Biochemistry and Behavior.

[14]  Abraham Zangen,et al.  Brain stimulation in the study and treatment of addiction , 2010, Neuroscience & Biobehavioral Reviews.

[15]  K. Sher,et al.  Characteristics of children of alcoholics: putative risk factors, substance use and abuse, and psychopathology. , 1991, Journal of abnormal psychology.

[16]  Reinout W. Wiers,et al.  Getting a Grip on Drinking Behavior , 2011, Psychological science.

[17]  J. Strang,et al.  Changes in Neuropsychological Functioning during Alcohol Detoxification , 2008, European Addiction Research.

[18]  P. Reuter World drug report , 1998 .

[19]  R. Sinha,et al.  Difficulties in emotion regulation and impulse control during cocaine abstinence. , 2007, Drug and alcohol dependence.

[20]  A. Pfefferbaum,et al.  Improvement in memory and static balance with abstinence in alcoholic men and women: Selective relations with change in brain structure , 2007, Psychiatry Research: Neuroimaging.

[21]  Jack Coulehan,et al.  Family History , 2014, Annals of Internal Medicine.

[22]  A. Heinz,et al.  Correlation of stable elevations in striatal mu-opioid receptor availability in detoxified alcoholic patients with alcohol craving: a positron emission tomography study using carbon 11-labeled carfentanil. , 2005, Archives of general psychiatry.

[23]  John A Cunningham,et al.  Is alcohol dependence best viewed as a chronic relapsing disorder? , 2012, Addiction.

[24]  M. Zack,et al.  Effects of the atypical stimulant modafinil on a brief gambling episode in pathological gamblers with high vs. low impulsivity , 2009, Journal of psychopharmacology.

[25]  John J. Foxe,et al.  Assessing white matter integrity as a function of abstinence duration in former cocaine-dependent individuals. , 2010, Drug and alcohol dependence.

[26]  J. Luigjes,et al.  Deep brain stimulation in addiction: a review of potential brain targets , 2012, Molecular Psychiatry.

[27]  R. Engle,et al.  The role of prefrontal cortex in working-memory capacity, executive attention, and general fluid intelligence: An individual-differences perspective , 2002, Psychonomic bulletin & review.

[28]  Catherine A. Sugar,et al.  Acute modafinil effects on attention and inhibitory control in methamphetamine-dependent humans. , 2011, Journal of studies on alcohol and drugs.

[29]  Jennifer M. Glass,et al.  Neuropsychological executive functioning in children at elevated risk for alcoholism: findings in early adolescence. , 2004, Journal of abnormal psychology.

[30]  H. Markowitsch,et al.  Cognitive performance of detoxified alcoholic Korsakoff syndrome patients remains stable over two years , 2008, Journal of clinical and experimental neuropsychology.

[31]  P. Fried,et al.  Neurocognitive consequences of marihuana--a comparison with pre-drug performance. , 2005, Neurotoxicology and teratology.

[32]  V. Sturm,et al.  Remission of alcohol dependency following deep brain stimulation of the nucleus accumbens: valuable therapeutic implications? , 2009, BMJ Case Reports.

[33]  Glen P. Davis,et al.  Association between cannabis use, psychosis, and schizotypal personality disorder: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions , 2013, Schizophrenia Research.

[34]  L. Schmaal,et al.  Effect of modafinil on impulsivity and relapse in alcohol dependent patients: A randomized, placebo-controlled trial , 2013, European Neuropsychopharmacology.

[35]  Nora D. Volkow,et al.  The addicted human brain viewed in the light of imaging studies: brain circuits and treatment strategies , 2004, Neuropharmacology.

[36]  Stefan M. Gruenert,et al.  Addiction: A Disorder of Choice , 2010 .

[37]  W. van den Brink,et al.  Neurophysiological effects of modafinil on cue-exposure in cocaine dependence: a randomized placebo-controlled cross-over study using pharmacological fMRI. , 2013, Addictive Behaviours.

[38]  M. Mimura,et al.  Family history of alcoholism and cognitive recovery in subacute withdrawal , 2006, Psychiatry and clinical neurosciences.

[39]  A. Zangen,et al.  Repeated high-frequency transcranial magnetic stimulation over the dorsolateral prefrontal cortex reduces cigarette craving and consumption. , 2009, Addiction.

[40]  Galantamine attenuates some of the subjective effects of intravenous nicotine and improves performance on a Go No-Go task in abstinent cigarette smokers: a preliminary report , 2012, Psychopharmacology.

[41]  S. Tapert,et al.  Impact of Adolescent Alcohol and Drug Use on Neuropsychological Functioning in Young Adulthood: 10-Year Outcomes , 2011, Journal of child & adolescent substance abuse.

[42]  Andrew R. A. Conway,et al.  A controlled-attention view of working-memory capacity. , 2001, Journal of experimental psychology. General.

[43]  Paul E. Meehl,et al.  Nuisance variables and the ex post facto design , 1970 .

[44]  Andrew Mathews,et al.  Cognitive bias modification approaches to anxiety. , 2012, Annual review of clinical psychology.

[45]  G. Patton,et al.  Cannabis use and educational achievement: findings from three Australasian cohort studies. , 2010, Drug and alcohol dependence.

[46]  Reinout W Wiers,et al.  Clinical effectiveness of attentional bias modification training in abstinent alcoholic patients. , 2010, Drug and alcohol dependence.

[47]  Stefan Gazdzinski,et al.  Temporal dynamics and determinants of whole brain tissue volume changes during recovery from alcohol dependence. , 2005, Drug and alcohol dependence.

[48]  D. Hardin,et al.  Chronic cigarette smoking modulates injury and short-term recovery of the medial temporal lobe in alcoholics , 2008, Psychiatry Research: Neuroimaging.

[49]  Reinout W. Wiers,et al.  Cognitive Bias Modification and Cognitive Control Training in Addiction and Related Psychopathology , 2013 .

[50]  A. Leshner Addiction is a brain disease, and it matters. , 1997, Science.

[51]  Reinout W. Wiers,et al.  Approach bias modification in alcohol dependence: Do clinical effects replicate and for whom does it work best? , 2013, Developmental Cognitive Neuroscience.

[52]  Keith W Kelley,et al.  NIH public access policy , 2008, Brain, Behavior, and Immunity.

[53]  A. Bechara Decision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective , 2005, Nature Neuroscience.

[54]  L Solymosi,et al.  Sequential MR imaging and proton MR spectroscopy in patients who underwent recent detoxification for chronic alcoholism: correlation with clinical and neuropsychological data. , 2001, AJNR. American journal of neuroradiology.

[55]  S. Potvin,et al.  Widespread and sustained cognitive deficits in alcoholism: a meta‐analysis , 2013, Addiction biology.

[56]  F. Strack,et al.  Reflective and Impulsive Determinants of Social Behavior , 2004, Personality and social psychology review : an official journal of the Society for Personality and Social Psychology, Inc.

[57]  A. Pfefferbaum,et al.  Recovery of short-term memory and psychomotor speed but not postural stability with long-term sobriety in alcoholic women. , 2004, Neuropsychology.

[58]  M. J. Emerson,et al.  The Unity and Diversity of Executive Functions and Their Contributions to Complex “Frontal Lobe” Tasks: A Latent Variable Analysis , 2000, Cognitive Psychology.

[59]  J. Monterosso,et al.  Methamphetamine dependence and neuropsychological functioning: evaluating change during early abstinence. , 2010, Journal of studies on alcohol and drugs.

[60]  K. Hutchison,et al.  Brain‐derived neurotrophic factor genotype is associated with brain gray and white matter tissue volumes recovery in abstinent alcohol‐dependent individuals , 2013, Genes, brain, and behavior.

[61]  J. Orford,et al.  Addiction as excessive appetite. , 2001, Addiction.

[62]  R. V. van Holst,et al.  Drug-related decrease in neuropsychological functions of abstinent drug users. , 2011, Current drug abuse reviews.

[63]  E. Nickel,et al.  Do premorbid predictors of alcohol dependence also predict the failure to recover from alcoholism? , 2010, Journal of studies on alcohol and drugs.

[64]  Donna J. Calu,et al.  Opiate versus psychostimulant addiction: the differences do matter , 2011, Nature Reviews Neuroscience.

[65]  H. Roeyers,et al.  Impulsivity as a vulnerability factor for poor addiction treatment outcomes: a review of neurocognitive findings among individuals with substance use disorders. , 2014, Journal of substance abuse treatment.

[66]  D. Yurgelun-Todd,et al.  Neuropsychological performance in long-term cannabis users. , 2001, Archives of general psychiatry.

[67]  I. Grant,et al.  Longer term improvement in neurocognitive functioning and affective distress among methamphetamine users who achieve stable abstinence , 2010, Journal of clinical and experimental neuropsychology.

[68]  M. Daly Personality may explain the association between cannabis use and neuropsychological impairment , 2013, Proceedings of the National Academy of Sciences.

[69]  M. Bates,et al.  A Role for Cognitive Rehabilitation in Increasing the Effectiveness of Treatment for Alcohol Use Disorders , 2013, Neuropsychology Review.

[70]  Marilyn A Huestis,et al.  Cognitive Measures in Long‐Term Cannabis Users , 2002, Journal of clinical pharmacology.

[71]  George Fein,et al.  Neuropsychological performance of individuals dependent on crack-cocaine, or crack-cocaine and alcohol, at 6 weeks and 6 months of abstinence. , 2002, Drug and alcohol dependence.

[72]  Vyv Huddy,et al.  A Meta-Analysis of Cognitive Remediation for Schizophrenia: Methodology and Effect Sizes , 2012 .

[73]  Janet B W Williams,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[74]  David Coghill,et al.  Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. , 2013, The American journal of psychiatry.

[75]  Mark Jenkinson,et al.  Manifestations of early brain recovery associated with abstinence from alcoholism. , 2006, Brain : a journal of neurology.

[76]  Aribert Rothenberger,et al.  Distinct EEG effects related to neurofeedback training in children with ADHD: a randomized controlled trial. , 2009, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[77]  R P Mattick,et al.  Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. , 2009, The Cochrane database of systematic reviews.

[78]  W. van den Brink,et al.  Attentional bias predicts heroin relapse following treatment. , 2006, Addiction.

[79]  T. Klingberg Training and plasticity of working memory , 2010, Trends in Cognitive Sciences.

[80]  Richie Poulton,et al.  Persistent cannabis users show neuropsychological decline from childhood to midlife , 2012, Proceedings of the National Academy of Sciences.

[81]  R. Wiers,et al.  Retraining automatic action-tendencies to approach alcohol in hazardous drinkers. , 2010, Addiction.

[82]  Kevin A. Johnson,et al.  Volitional reduction of anterior cingulate cortex activity produces decreased cue craving in smoking cessation: a preliminary real‐time fMRI study , 2013, Addiction biology.

[83]  Bettina Sorger,et al.  Real-Time Self-Regulation of Emotion Networks in Patients with Depression , 2012, PloS one.

[84]  A. Caspi,et al.  Reply to Rogeberg and Daly: No evidence that socioeconomic status or personality differences confound the association between cannabis use and IQ decline , 2013, Proceedings of the National Academy of Sciences.

[85]  E. Smeraldi,et al.  Daily sessions of transcranial magnetic stimulation to the left prefrontal cortex gradually reduce cocaine craving. , 2008, The American journal on addictions.

[86]  D. Ziedonis,et al.  Addressing tobacco use disorder in smokers in early remission from alcohol dependence: the case for integrating smoking cessation services in substance use disorder treatment programs. , 2010, Clinical psychology review.

[87]  Li-yan Zhao,et al.  Effects of stress on decision-making deficits in formerly heroin-dependent patients after different durations of abstinence. , 2011, The American journal of psychiatry.

[88]  W. Hulstijn,et al.  Impulsivity in abstinent early- and late-onset alcoholics: differences in self-report measures and a discounting task. , 2006, Addiction.

[89]  E. Constant,et al.  Distinct effects of protracted withdrawal on affect, craving, selective attention and executive functions among alcohol-dependent patients. , 2010, Alcohol and Alcoholism.

[90]  F. W. Black,et al.  CHARACTERISTICS OF CHILDREN , 1976 .

[91]  H. Flor,et al.  Effects of repeated withdrawal from alcohol on recovery of cognitive impairment under abstinence and rate of relapse. , 2010, Alcohol and alcoholism.

[92]  A. Weinstein,et al.  Effects of contextual priming on reactions to craving and withdrawal stimuli in alcohol-dependent participants. , 2001, Experimental and clinical psychopharmacology.

[93]  Nikolaus Weiskopf,et al.  Real-time fMRI and its application to neurofeedback , 2012, NeuroImage.

[94]  D. Meyerhoff,et al.  Chronic smoking is associated with differential neurocognitive recovery in abstinent alcoholic patients: a preliminary investigation. , 2007, Alcoholism, clinical and experimental research.

[95]  Linda Chang,et al.  Adaptation of Brain Glutamate Plus Glutamine during Abstinence from Chronic Methamphetamine Use , 2008, Journal of Neuroimmune Pharmacology.

[96]  S. McDonald,et al.  Deficits in social perception in opioid maintenance patients, abstinent opioid users and non-opioid users. , 2013, Addiction.

[97]  Min Zhao,et al.  Cue-induced craving and physiological reactions in recently and long-abstinent heroin-dependent patients. , 2012, Addictive behaviors.

[98]  R. Pihl,et al.  Cognitive dysfunction and the inherited predisposition to alcoholism. , 1992, Journal of studies on alcohol.

[99]  O. Røgeberg Reply to Moffitt et al.: Causal inference from observational data remains difficult , 2013, Proceedings of the National Academy of Sciences.

[100]  K. R. Ridderinkhof,et al.  Neural responses associated with cue‐reactivity in frequent cannabis users , 2013, Addiction biology.

[101]  Rex L. Cannon,et al.  EEG Biofeedback as a Treatment for Substance Use Disorders: Review, Rating of Efficacy, and Recommendations for Further Research , 2008, Applied psychophysiology and biofeedback.

[102]  S. Tapert,et al.  The Influence of Recency of Use on fMRI Response During Spatial Working Memory in Adolescent Marijuana Users , 2010, Journal of psychoactive drugs.

[103]  R. Wiers,et al.  Retraining Automatic Action Tendencies Changes Alcoholic Patients’ Approach Bias for Alcohol and Improves Treatment Outcome , 2011, Psychological science.

[104]  B. Desgranges,et al.  Changes in the episodic memory and executive functions of abstinent and relapsed alcoholics over a 6-month period. , 2009, Alcoholism, clinical and experimental research.

[105]  K O Lim,et al.  Longitudinal changes in cognition, gait, and balance in abstinent and relapsed alcoholic men: relationships to changes in brain structure. , 2000, Neuropsychology.

[106]  M. Pérez-García,et al.  What are the specific vs. generalized effects of drugs of abuse on neuropsychological performance? , 2011, Neuroscience & Biobehavioral Reviews.

[107]  A. Heinz,et al.  Effects of alcoholism and continued abstinence on brain volumes in both genders. , 2011, Alcoholism, clinical and experimental research.