Cognitive Functional Impairment In Patients With Alcohol Dependence:Neuropsychological And Diffusion Tensor Imaging Study

Objective Combined clinical assessments with neuropsychological test to assess the cognitive impairment induced by alcohol dependence patients.To detect the fiber structure differences in corpus callosum between alcohol dependent patients and the normal control by fiber tractography based on diffusion tensor imaging,and to investigate the relationship between cognitive impairment and fibers of corpus callosum.Methods Forty-eight patients with alcohol dependence and fifty matched healthy controls underwent clock drawing test(CDT)and Montreal cognitive assessment(MoCA)scale inspection,respectively.Neuropsychological test was applied to measure the differences of response inhibition and working memory between the two groups.T1-weighted magnetic resonance imaging and diffusion tensor imaging were obtained in 48 alcohol dependent patients and 50-age,sex,education year-matched normal controls.The differences of the fiber fractional anisotropy(FA),fiber apparent diffusion coefficient(ADC),fiber number,average fiber length of the corpus callosum between the two groups were measured.Results CDT scores of alcoholic subjects were significantly lower than those of control group(t=-0.92,P=0.00),MoCA total scores and executive functions,attention,calculation,ion,recall scores of alcoholic subjects were significantly lower than those of control group(t=-6.87,P=0.00;t]-4.37,P=0.00;t=-2.43,P=0.00;t=-7.09,P=0.00;t=-11.56,P=0.00;t=-9.25,P=0.00).The drinking duration were negatively correlated with CDT scores,MoCA total scores,executive functions scores,ion scores and recall scores(P<0.05).The alcohol consumption distribution in grams per day of pure alcohol were negatively correlated with CDT scores,MoCA total scores,executive functions scores and abstraction scores(P<0.05).In the response inhibition task,the patient group had more commission errors[(7.02±3.48)vs.(3.45± 1.52)]and longer reaction time[(605.45±142.56)vs.(435.72±51.18)]compared to the control group(t=6.534,P=0.000;=7.781,P=0.000).In the spatial working memory task,the patient group also had more commission errors[(4..58±3.45)vs.(0.43±0.88)]and longer reaction time[(10566.16±2455.61)vs.(9185.44±2677.52)]than control(t=8,085,P=0.000;t=2.657,P=0.009).Compared with the control group,the fibers number of total corpus callosum in the alcohol dependent patients were significantly decreased(t=-2.010,P=0.047),the FA values were significantly decreased(t=-2.474,P= 0.015),and ADC values were significantly increased(t= 2.121,P= 0.037).While the fibers number in anterior third of corpus callosum were reduced(t=-4.075,P= 0.000),FA values were decreased(t=-3.299,P= 0.001),ADC values were increased(t= 6.980,P= 0.000).Conclusion Patients with alcohol dependence suffered cognitive impairment and the severity of cognitive impairment were correlated with the drinking duration and alcohol consumption distribution in grams per day of pure alcohol.There are significant deficiencies in response inhibition and working memory in patients with alcohol dependence.Fibers connectivity of the corpus callosum were affected in alcohol dependent patients and fibers of anterior third of corpus callosum were severely affected.