Increased Distractibility by Task-Irrelevant Sound Changes in Abstinent Alcoholics Jyrki Ahveninen, Iiro P. Jääskeläinen, Eero Pekkonen, Anja Hallberg, Marja Hietanen, Risto Näätänen, Erich Schröger, and Pekka Sillanaukee Background: Chronic alcoholism is accompanied by “frontal” neuropsychological deficits that include an inability to maintain focus of attention. This might be associated with pronounced involuntary attention shifting to task-irrelevant stimulus changes and, thereafter, an impaired reorienting to the relevant task. The neural abnormalities that underlie such deficits in alcoholics were explored with event-related poten- tial (ERP) components that disclosed different phases of detection and orienting to stimulus changes. Methods: Twenty consecutive abstinent male alcoholics (DSM-IV) and 20 age-matched male controls (healthy social drinkers) were instructed to discriminate equiprobable 100 and 200 msec tones in a reaction- time task (RT) and to ignore occasional, either slight (7%) or wide (70%), frequency changes (hypothesized to increase RT) during an ERP measurement. Results: In the alcoholics, we found pronounced distractibility, evidenced by a RT lag (p  0.01) caused by deviants, that correlated (Spearman  = 0.5) with a significantly enhanced (p  0.01) amplitude of mismatch negativity (MMN) to deviants. Significantly increased RT lag for trials subsequent to deviants (slight p  0.001, wide p  0.05) in the alcoholics suggested impaired reorienting to the relevant task. The MMN enhancement also predicted poorer hit rates in the alcoholics (Spearman  = 0.6 – 0.7). Both the MMN enhancement and pronounced distractibility correlated (Spearman  = 0.4) with an early onset of alcoholism. Conclusions: Attentional deficits in the abstinent alcoholics were indicated by the increased distracti- bility by irrelevant sound changes. The MMN enhancement suggested that this reflects impaired neural inhibition of involuntary attention shifting, being most pronounced in early-onset alcoholics. Key Words: Alcoholism, EEG, Auditory Event-Related Potentials, Involuntary Attention Shifting, Mismatch Negativity (MMN). A LCOHOLISM IS ONE of the leading public health problems in the Western world, with high incidence, vast economic costs, and, notably, a poor treatment re- sponse (McCrady and Langenbucher, 1996). Better under- standing of the cognitive and neural deficits that underlie and follow this disorder clearly is needed. Alcoholism often is associated with sensation seeking and impulsive behavior (Andrucci et al., 1989; Gorenstein and Newman, 1980). Accordingly, deficits in frontal brain regions that control goal-directed behavior have been shown in postmortem investigations (Harper et al., 1987; Kril and Harper, 1989), as well as studies that correlate cerebral perfusion or metabolism with neuropsychological impairments in alcoholics (Dao-Castellana et al., 1998; Nicolás et al., 1993). Event-related potential (ERP) studies have reported abnormalities in components that reflect voluntary allocation of attentional resources to relevant task features in alcoholics (Cohen et al., 1997; Porjesz and Begleiter, 1993) and, notably, also in individuals at high risk to develop alcoholism (Begleiter et al., 1984; Porjesz and Begleiter, 1993; Porjesz et al., 1998). For instance, ampli- tude reduction (Patterson et al., 1987; Pfefferbaum et al., 1991) and peak latency delay (Pfefferbaum et al., 1991, 1979; Steinhauer et al., 1987) of the P3b, a large attentional ERP component that peaks 300 to 500 msec after target- stimulus onset, have been found in alcoholics. Alcohol- dependent individuals also might be pronouncedly dis- tracted by disease-related stimuli (e.g., alcohol-related words) during selective-attention tasks (Stetter et al., 1994, 1995). However, few studies on alcoholism have concen- trated on the cerebral basis of involuntary attention shift- ing, a fundamental function that allows the individual to orient to unexpected, potentially harmful, changes in the environment (Näätänen, 1992) but needs to be controlled when one is concentrating on goal-directed functioning. From the Cognitive Brain Research Unit (JA, IPJ, EP, RN), Department of Psychology, and the Department of Neurology (MH), University of Hel- sinki, Finland; Järvenpää Social Hospital (AH), A-Clinic Foundation, Jär- venpää, Finland; the Institute for General Psychology (ES), University of Leipzig, Germany; and the Research Unit (PS), Tampere University Hospital, Finland. Received for publication April 25, 2000; accepted September 20, 2000. The study was supported by the Finnish Foundation for Alcohol Studies, the Finnish Cultural Foundation, the Ella and Georg Ehrnrooth’s Founda- tion, and the Academy of Finland. Reprint requests: Jyrki Ahveninen, MA, Cognitive Brain Research Unit, Department of Psychology, P.O. Box 13, FIN-00014 University of Helsinki, Finland; Fax: 358-9-191-22924; E-mail: jyrki.ahveninen@helsinki.fi Copyright © 2000 by the Research Society on Alcoholism. 0145-6008/00/2412-1850$03.00/0 ALCOHOLISM:CLINICAL AND EXPERIMENTAL RESEARCH Vol. 24, No. 12 December 2000 1850 Alcohol Clin Exp Res, Vol 24, No 12, 2000: pp 1850 –1854