慢性海洛因使用者认知功能及血浆BDNF的影响

A. Soliman, N. Zaki, Soheir H. El-Ghonemy, Reem El Ghamry, E. Shorub, M. Farag
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引用次数: 1

摘要

背景:最近的证据表明,滥用药物可能改变大脑区域的正常结构,影响功能,诱发认知缺陷,促进持续吸毒。目的:本研究的目的是评估慢性海洛因使用患者的认知功能障碍模式,并探讨其与脑源性神经营养因子(BDNF)血浆水平的关系。方法:根据《精神疾病诊断与统计手册》第四版(DSM-IV),从艾因沙姆斯大学精神病学研究所的住院部和门诊部招募了50例慢性海洛因使用患者(病例组),并与由38名频率匹配的健康志愿者组成的对照组进行了比较。各组进行以下检查:(1)临床精神病学检查,(2)DSMIV结构化临床访谈(SCID-I),(3)患者组成瘾严重程度指数,(4)韦氏成人智力量表,(5)韦氏记忆量表,(6)威斯康星卡片分类测验(计算机版)评估认知功能,(7)测定血浆BDNF水平。结果:病例组存在明显的认知功能障碍和认知功能差。总智力功能、视觉、语言、即时记忆和执行功能均有统计学意义(P<0.005)。虽然BDNF血浆水平与不同神经认知功能之间无显著性差异,但病例组中BDNF血浆水平较高。局限性:由于目前的研究是一项横断面研究,因此无法评估发病前的认知能力。结论:慢性海洛因滥用者存在多领域认知功能障碍,可能导致其继续使用海洛因。心理治疗项目应考虑这些发现,以更好地影响患者的生活质量和整体治疗结果。
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Cognitive Functions and Impact of Plasma BDNF in Chronic Heroin Users
Background: Recent evidence suggests that abusing drugs may alter the normal structure in brain regions and influence functions that induce cognitive deficits and promote continued drug use. Objective: The objective of this studywas to assess the pattern of cognitive dysfunctions in patients with chronic heroin use and to explore any relation to brain-derived neurotrophic factor (BDNF) plasma level. Method: This was a case-control naturalistic cross-sectional study of 50 patients (case group) with chronic heroin use according toDiagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) who were recruited from the inpatient unit and outpatient clinics of Institute of Psychiatry, Ain Shams University, and were further compared with a control group that consisted of 38 frequency-matched healthy volunteers. The groups were subjected to the following: (1) clinical psychiatric examination, (2) Structured Clinical Interview for DSMIV (SCID-I), (3) Addiction Severity Index for the patients’ group, (4) Wechsler Adults Intelligence Scale, (5) Wechsler Memory Scale, (6) Wisconsin Card Sorting Test— computerized version was performed to assess cognitive functions, and (7) measuring BDNF plasma level. Results: Definite cognitive function impairment and poor cognitive domains were detected among the case group. Total intellectual functions, and visual, verbal, immediate memory, and executive functions were statistically significant (P<0.005). Although, there was no significance between BDNF plasma level and different neurocognitive functions, higher BDNF plasma level among the case group was detected. Limitation: Premorbid cognitive abilities could not be assessed, as the current study was a cross-sectional study. Conclusions: Those with chronic heroin use suffer from cognitive dysfunction of multiple domains that may contribute to their continued drug use. Psychotherapeutic programs should consider these findings in their approaches for better impact on patients’ quality of life and overall treatment outcome.
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期刊介绍: Addictive Disorders & Their Treatment is a quarterly international journal devoted to practical clinical research and treatment issues related to the misuses of alcohol and licit and illicit drugs and the study and treatment of addictive disorders and their behaviors. The journal publishes broad-spectrum, patient-oriented coverage of all aspects of addiction, directed toward an audience of psychiatrists, clinical psychologists, psychopharmacologists, and primary care practitioners. Original articles help clinicians make more educated, effective decisions regarding optimal patient management and care. In-depth reviews examine current understanding, diagnosis, and treatment of addiction disorders.
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