Towards a Dynamic Exploration of Vision, Cognition and Emotion in Alcohol-Use Disorders

Visuoperceptive impairments are among the most frequently reported deficits in alcoholuse disorders, but only very few studies have investigated their origin and interactions with other categories of dysfunctions. Besides, these deficits have generally been interpreted in a linear bottom- up perspective, which appears very restrictive with respect to the new models of vision developed in healthy populations. Indeed, new theories highlight the predictive nature of the visual system and demonstrate that it interacts with higher-level cognitive functions to generate top-down predictions. These models notably posit that a fast but coarse visual analysis involving magnocellular pathways helps to compute heuristic guesses regarding the identity and affective value of inputs, which are used to facilitate conscious visual recognition. Building on these new proposals, the present review stresses the need to reconsider visual deficits in alcohol-use disorders as they might have crucial significance for core features of the pathology, such as attentional bias, loss of inhibitory control and emotion decoding impairments. Centrally, we suggest that individuals with severe alcohol-use disorders could present with magnocellular damage and we defend a dynamic explanation of the deficits. Rather than being restricted to high-level processes, deficits could start at early visual stages and then extend and potentially intensify during following steps due to reduced cerebral connectivity and dysfunctional cognitive/emotional regions. A new research agenda is specifically provided to test these hypotheses.