Sobriety can result in improvement in brain structure and function, indicative of either damage reversal (i.e., actual recovery) or compensatory mechanisms that can be identified with neuropsychological testing and quantitative structural or functional brain imaging. Tracking alcoholism’s dynamic course of sobriety and relapse reveals the potential for recovery from and accommodation (i.e., compensation) to neural and neuropsychological insult. Functional imaging studies provide evidence for compensation by invoking non-normal sites and circuits to achieve normal performance on tasks typically impaired (Chanraud et al., 2013; Oscar-Berman and Marinkovic, 2007; Sullivan and Pfefferbaum, 2005), occurring at the cost of processing efficiency when patients perform in the normal range but need additional time to achieve this level (Nixon and Parsons, 1991; Sullivan and Pfefferbaum, 2005). Recovery from cognitive impairment in abstinent alcoholics is typically investigated with cross-sectional designs, comparing alcoholic groups with different lengths of sobriety varying from days to several years to each other or with a control group of healthy participants (e.g., Brandt et al., 1983; Hochla et al., 1982; Markowitsch et al., 1986; Munro et al., 2000; Reed et al., 1992).
