Recovery of Executive Functions in Alcohol Use Disorder: role of Neuropsychological Rehabilitation

Abstract Background Alcohol Use Disorder (AUD) is a growing public health concern with high incidence of executive functions (EFs) changes, affecting disease progression and treatment effectiveness. Inconsistencies persist in studies on the role of neuropsychological rehabilitation (NR) in EF recovery within AUD interventions. Our aim is to analyse the effect of NR on EFs in AUD interventions. Methods A prospective cohort study included 65 participants of both sexes, diagnosed with AUD, free of psychiatric comorbidities or severe neurological conditions. They underwent alcohol detoxification in hospital/home from 2021 to 2023, completing three evaluation moments (M1-Baseline, M2-3 months, M3-6 months). Patients receiving usual treatment (WTG-weekly therapeutic groups) - were compared to those with additional Neuropsychological Rehabilitation (NRG) regarding Sociodemographic and Severity of Alcohol Dependence Questionnaires, Hospital Anxiety and Depression Scale, Frontal Assessment Battery (FAB), Number and Letters Subscale of Weschler Adult Intelligence Scale (WAIS). Our main outcome was FAB-general executive functioning, and secondary outcome was WAIS-working memory. Friedman test compared assessments across the three points (alpha 5%). Results Statistically significant differences were found for FAB in both groups, (p < 0.001) between M1 and both M2 and M3, indicating improved executive functioning, particularly in NRG. Working memory also improved in both groups (WTG: p = 0.036; NRG: p < 0.001), with NRG showing better M2 performance. Conclusions There is evidence that neuropsychological rehabilitation facilitates the recovery of executive functions and may play a pivotal role in relapse prevention. It is crucial that the treatment of these situations incorporates public health, preventive and damage minimization measures. KeyWords: Executive Function; Neuropsychological Rehabilitation; Alcohol Use Disorder. Key messages • Recovery of executive functions is crucial from a Public Heath perspective in AUD populations, minimizing morbidity, permanent disabilities and contributing to more effective healthcare services. • Integrating Neuropsychological Rehabilitation into standard Alcohol Use Disorder treatments can enhance treatment effectiveness, reducing disease burden.