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Xavier Noël, PhD; Martial Van der Linden, PhD; Nicolas Schmidt; Rita Sferrazza, MD; Catherine Hanak, MD; Olivier Le Bon, MD; Jacques De Mol, PhD; Charles Kornreich, MD; Isidore Pelc, MD, PhD; Paul Verbanck, MD, PhD

Arch Gen Psychiatry. 2001;58:1152-1158.

Background  Many studies have shown that recently detoxified alcoholic persons perform poorly on tasks thought to be sensitive to frontal lobe damage, supporting the hypothesis that the frontal lobes are highly vulnerable to chronic alcohol consumption. However, it appeared that most of the executive tasks used in these studies also involved nonexecutive components, and these tasks had been shown to be impaired as a result of nonfrontal lobe lesions. In this study, we examined further the "frontal lobe vulnerability" hypothesis using executive tasks, proved to be associated with frontal lobe functioning, that allowed us to distinguish the relative importance of executive and nonexecutive processes.

Method  Thirty recently detoxified asymptomatic male alcoholic inpatients and 30 control subjects were tested for planning, inhibition, rule detection, and coordination of dual task, as well as the speed of processing and nonexecutive functions (such as short-term memory storage).

Results  Alcoholics performed worse than controls in almost all tasks assessing executive functions. However, they were not slower than the controls and showed normal results for nonexecutive functions.

Conclusions  Chronic alcohol consumption seems to be associated with severe executive function deficits, which are still present after a protracted period of alcohol abstinence. These data support the idea that the cognitive deficits in recently detoxified sober alcoholic subjects are due, at least partly, to frontal lobe dysfunctioning.

From the Department of Psychiatry (Drs Noël, Sferrazza, Hanak, Le Bon, De Mol, Kornreich, Pelc, and Verbanck) and the Cognitive Sciences Research Unit (Mr Schmidt), Free University of Brussels, and the Psychiatric Institute, Brugmann University Hospital (Drs Noël, Sferrazza, Hanak, Le Bon, De Mol, Kornreich, Pelc, and Verbanck), Brussels, Belgium; and the Department of Cognitive Psychopathology, University of Geneva, Geneva, Switzerland (Dr Van der Linden).

Corresponding author and reprints: Xavier Noël, PhD, Psychiatric Institute, Brugmann University Hospital, Van Ghuchten 4, Brussels 1020, Belgium (e-mail: xnoel{at}ulb.ac.be).

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