Applicability of the ACE-III and RBANS cognitive tests for the detection of Alcohol-Related Brain Damage

Background: Recent investigations have highlighted the value of neuropsychological testing for the assessment and diagnosis of Alcohol-Related Brain Damage (ARBD).
Aims: To evaluate the suitability of the Addenbrooke’s Cognitive Examination (ACE-III) and the Repeatable Battery for the Assessment of Neuropsychological Status (R-BANS) fopr this purpose.
Methods: Comparing 28 participants with ARBD (11 Korsakoff’s Syndrome, 17 with ARBD diagnosis) and 30 alcohol-dependent participants without ARBD (ALs), we calculated Area Under the Curve (AUC) statistics, sensitivity and specificity values, base-rate adjusted predictive values, and likelihood ratios for both tests.
Results: High levels of diagnostic accuracy were found for the total scores of both the ACE- III (AUC = .823, SE = .056; optimal cut-off ≤86: sensitivity = 82%, specificity = 73%) and R- BANS (AUC = .846, SE = .052; optimal cut-off ≤83: sensitivity = 89%, specificity = 67%) at multiple cut-off points. When participants with a history of polysubstance use were removed from the samples (10 ALs and 1 ARBD), the diagnostic capabilities of the R-BANS improved substantially (AUC = .915, SE = .043; optimal cut-off ≤85: sensitivity = 98%, specificity = 80%), while only minor improvements to the ACE-III’s accuracy was observed (AUC = .854, SE = .056; optimal cut-off ≤88: sensitivity = 85%, specificity = 75%). Both tests produced similar diagnostic values, though the R-BANS was considerably superior with the omission of polysubstance misusers.
Conclusions: Overall, the findings suggest both ACE-III and R-BANS are suitable assessment tools for ARBD within an alcohol-dependent population, although the assessment of executive function in both is limited.