Triazolam-induced changes in alcoholic thought processes.

This study was designed to examine and contrast cognitive effects (explicit memory and access to semantic knowledge) of the benzodiazepine Halcion (triazolam) in ten normal volunteers and ten cognitively un-impaired detoxified alcoholics. The two groups were indistinguishable from one another under placebo conditions on all measures of cognitive functioning. Under Halcion test conditions (0.375 mg p.o.), both groups were about equally impaired in their recall of to-be-remembered information. However, alcoholics, were more likely to recall information that they were not asked to remember (intrusion errors) on all measures of explicit remembering. Alcoholics also generated relatively uncommon (low frequency) responses from semantic memory, rather than common, categorically related associations in response to stimuli such as types of vegetables, flowers, and fruit following the administration of Halcion, but were not different from normal volunteers in the types of responses generated under placebo conditions. These findings suggest that a drug challenge that simulates many of the effects of acute alcohol administration induces alcoholics to think and remember differently (qualitatively) from normal volunteers.

Perspectives on cognitive psychopharmacology research.

This article discusses new perspectives in the psychopharmacology of cognition and analyses the advantages and disadvantages of using drugs as tools to study the mechanisms underlying memory functions. The use of 'stages' in the processing of information as a means for the analysis of cognitive operations is critically discussed as a rigid approach which can only partially accommodate different cognitive functions. Theoretical models of memory 'systems' and allocation of attentional resources are presented alongside findings from the two types of more commonly used drugs in cognitive psychopharmacology: the benzodiazepines (BZ) and the anticholinergics. In a post-hoc analysis of the effects of BZ and scopolamine on memory and attention, it has become clear that these newer theoretical models can accommodate most, but not all, of the effects of BZ and scopolamine on cognition. It is suggested that the development of cognitive tasks on the basis of these models and the execution of prospective studies with drugs as tools taking in to account the 'systems' approach to interpretation of data may be more useful for understanding cognitive functions.

Monitoring the source of memory in detoxified alcoholics.

The ability to monitor the source of remembered information and related reflective cognitive processes was examined in normal volunteers and detoxified alcoholics. Normal volunteers were very accurate judges of whether remembered events were presented as stimuli or were self-generated, even when memory was tested 2 days later. In contrast, a subgroup of otherwise cognitively unimpaired alcoholics demonstrated impairments in the ability to track the source of remembered knowledge and were also less able to inhibit intrusion errors in recalling information from memory. These findings provide preliminary evidence of an impairment in cognitive control functions in certain alcoholics. This conclusion is supported by associated findings indicating that, among alcoholics, performance on explicit memory tasks that required reflective cognitive operations were positively correlated with glucose utilization rates in left prefrontal, temporal, and posterior orbital frontal cortical regions.

An effect of triazolam on visual attention and information processing.

This study explored whether benzodiazepines selectively affect aspects of attention and/or visual information processing, as they do memory. A cued visual-search paradigm was employed, using normal volunteers and a single dose of triazolam. This paradigm provided for a detailed examination of two aspects of visual attention and information processing: 1) controlled versus automatic attention allocation (via central and peripheral cues), and 2) the extent to which processing an item in a non-cued location affects performance (via cue-validity). Triazolam, compared to placebo, significantly increased response time, and Drug Condition interacted with Cue-Validity but not Cue-Type. Based on these data, we argue that triazolam does not affect attention allocation but does affect attentional disengagement and/or attention switching mechanisms.

Dissociations in the expression of the sedative effects of triazolam.

Fifteen normal volunteers were administered 0.250, 0.375, and 0.500 mg of triazolam and placebo in a double-blind repeated measures cross-over design. Subjects demonstrated dose-dependent impairments in free recall, a test of explicit memory requiring awareness and reflection, and sedation as assessed by objective behavioral measures (the digit symbol substitution task) and subjective visual analogue scales. The sedative drug response did not account for the impairment in free recall. Differences in performance of the two tests of sedation indicated that the effect of this drug on reflective processes accounts for impairment in episodic memory and the inability to track the sedative effects of this drug at the higher doses tested in this study.

Impairments in reflective cognitive functions in alcoholics: a neuropharmacological model.

The ability to make use of reflective cognitive operations in monitoring and evaluating remembered events is impaired in subgroups of nominally cognitively unimpaired, detoxified alcoholics. Alcoholics, relative to controls, make more errors in identifying the source of remembered information (i.e. whether a remembered word was self-generated or was a stimulus word presented by the experimenter), and are impaired in their ability to inhibit confabulatory errors (intrusions). The cognitive-memory impairment expressed in benzodiazepine-treated normal volunteers mimics this impairment in alcoholics. Disturbances in prefrontal and frontal lobe functions may be involved in this selective impairment in cognition in many alcoholics and may also contribute to what accounts for the failures in reflective cognitive operations observed in amnestic patients.

Changes in semantic memory in early stage Alzheimer's disease patients.

The types and number of exemplars of categories that are retrieved from semantic memory differentiate elderly normal controls and early stage Alzheimer's disease (AD) patients. Elderly normal controls generated more uncommon exemplars from closed semantic categories (fruits and vegetables) than did AD patients 2 1/2 years prior to the presumed onset of AD. AD patients, however, were just as productive as elderly normal controls in generating associations to open categories (letters). The findings suggest that one of the early cognitive symptoms of AD is changes in availability of uncommon exemplars of semantic networks.

Specific memory and sedative effects of the benzodiazepine triazolam.

Fifteen normal volunteers were administered placebo, 0.250, 0.375 and 0.500 mg of triazolam in a double- blind cross-over design. Triazolam induced robust dose-dependent impairments in explicit memory of information presented after drug administration. Subjects were unaware of their memory deficit (an impairment in meta-cognition). In contrast, memory for information presented prior to the administration of triazolam was facilitated following the administration of low doses of triazolam. Implicit memory and access to knowledge memory was unaltered by this benzodiazepine. An analysis of these results controlling for concurrent sedation as measured subjectively, through the use of self rating scales and objectively, based upon psychomotor performance, demonstrated that the amnestic effects of triazolam are largely independent of sedative effects. The pattern of memory changes induced by benzodiazepines, such as triazolam, is similar to the memory inpairment expressed in amnestic patients but unlike the pattern of impaired memory evident in dementia such as Alzheimer's disease.

Increased cognitive sensitivity to scopolamine with age and a perspective on the scopolamine model.

18 older normal volunteers (mean age = 66.5 +/- 7.9 years) and 46 younger volunteers (mean age = 27.0 +/- 6.1 years) were administered the anticholinergic drug scopolamine (0.5 mg i.v.) followed by a battery of cognitive tests evaluating attention, learning and memory. The older subjects were significantly more impaired than the younger by scopolamine on some tests of learning and memory. This increased sensitivity of the older group to scopolamine is consistent with studies in animals and humans showing decreased cholinergic system function with age. The findings also indicate that age is an important variable to consider in using the scopolamine model of memory impairment. The cognitive impairment caused by scopolamine in younger subjects in this and prior studies is similar to some, but not all aspects of the impairment which occurs in normal aging. Scopolamine also caused impairments on digit span and word fluency tasks, which are not consistent with normal aging changes. In the older group of subjects, scopolamine produced aspects of the cognitive impairment which occurs in AD on tests of episodic memory and learning, vigilance-attention, category retrieval, digit span, and number of intrusions. Other areas of cognition that are of relevance to aging and AD such as psychomotor speed, praxis, concept formation and remote memory were not evaluated in this study. Some of these are being evaluated in ongoing studies, along with additional and more specific tests of retrieval from knowledge memory, implicit memory and attention. The scopolamine model has provided a fruitful pharmacologic starting point for the study of a number of cognitive operations. The idea of dissecting apart aspects of memory systems pharmacologically depends on the availability of neurochemically specific drugs and on the specificity and sensitivity of neuropsychological tests for distinct cognitive operations or domains. Further studies using such tools will aid not only in the understanding of the impairments which occur in aging and in AD, but also of the conceptualization of memory and other cognitive operations and ultimately the physiological mechanisms involved in memory and learning.

Selective effects of triazolam on memory.

The effects of benzodiazepine (triazolam 0.25 and 0.50 mg) on different aspects of cognitive function were assessed. Triazolam impaired free recall and recognition of information presented after drug administration. In contrast to these impairments in explicit memory, a memory function that did not require conscious awareness was not altered by triazolam. Similarly, triazolam did not affect subjects' abilities to access semantic memory.

Dissociation of the acute effects of alcohol on implicit and explicit memory processes.

The effects of alcohol (0, 0.3 and 0.6 g/kg) on learning and memory were assessed in independent groups of male student volunteers. Subjects were shown a list of words and asked to form an image of a scene involving each word 1 hr after drinking an alcohol-containing beverage. Alcohol consumption impaired the ability of subjects to explicitly remember the words in a test of free recall. However, no impairment was observed if memory for the same material was assessed implicitly using a backwards-reading or word-completion task. That is, both alcohol-and placebo-treated subjects showed similar degrees of priming. The data indicate that alcohol's effects on memory are selective.

TRH attenuates scopolamine-induced memory impairment in humans.

The brain tripeptide thyrotropin-releasing hormone (TRH) has been demonstrated to facilitate cholinergic neurotransmission. To test its interaction with the cholinergic system in humans, high-dose TRH (0.5 mg/kg) or placebo was administered intravenously (IV) to normal controls pretreated with scopolamine (0.5-0.75 mg IV), a centrally active muscarinic antagonist, which has been used to model aspects of the memory impairment of normal aging and of dementia. Compared to placebo, TRH markedly attenuated scopolamine-induced impairment of some measures of memory, most notably on a selective reminding task. This cognitive study is the first in humans to suggest a neuromodulatory effect of a peptide on the cholinergic system, and suggests a facilitatory role for TRH in human memory processes.

Psychobiological modeling of age-related memory changes.

Useful models of age-related human and animal memory changes should simulate specific features of cognitive impairment associated with aging. It is necessary but not sufficient to demonstrate that manipulations such as those produced by lesions and drugs cause impairments in some cognitive function such as memory. A useful model should be able to reproduce a pattern of cognitive changes in which islands of spared versus impaired functioning resemble those associated with aging and differ from those produced by other conditions. This requires the use of research strategies utilizing multivariate treatment and dependent measure designs. The papers in this section illustrate the value of such a research approach.

Neuropharmacological strategies for understanding psychobiological determinants of cognition.

Psychopharmacological methods that have proven useful in exploring brain processes can be helpful in describing the psychobiological determinants of distinct cognitive processes. The methods and theory in current cognitive science can be exploited by neuropharmacologists interested not only in describing brain function but in building a viable picture of brain-behavior (cognitive) relationships. This paper provides a sketch of our knowledge about the neuropharmacology of cognitive processes. It also cites some questions, problems and approaches for further research efforts that would help us describe the psychobiology of cognition.