Durazzo Timothy C, Rothlind Johannes C, Gazdzinski Stefan, Banys Peter, Meyerhoff Dieter J
San Francisco Veterans Administration Medical Center, San Francisco, CA 94121, USA.
Alcohol Clin Exp Res. 2007 Jul;31(7):1114-27. doi: 10.1111/j.1530-0277.2007.00398.x. Epub 2007 Apr 19.
Approximately 50 to 90% of individuals in North America seeking treatment for alcoholism are chronic smokers. A growing body of evidence suggests that chronic cigarette smokers show a pattern of neurocognitive dysfunction similar to that observed in alcoholic patients. However, previous studies investigating neurocognitive recovery in abstinent alcoholic patients did not specifically consider the potential effects of chronic cigarette smoking.
This study comprehensively compared longitudinal neurocognitive changes over 6 to 9 months of abstinence among 13 nonsmoking recovering alcoholic patients (ALC) and 12 actively smoking ALC. The neurocognitive performance of the alcoholic groups was compared with nonsmoking light-drinking controls (nonsmoking LD).
Nonsmoking ALC exhibited a significantly greater magnitude of longitudinal improvement than smoking ALC on measures of cognitive efficiency, executive skills, visuospatial skills, and working memory. Both nonsmoking ALC and smoking ALC demonstrated equivalent improvement on auditory-verbal learning, auditory-verbal memory, and processing speed. Nonsmoking LD showed no significant changes in neurocognition over time. In cross-sectional comparisons at 6 to 9 months of abstinence, nonsmoking ALC were superior to smoking ALC on measures of auditory-verbal learning, auditory-verbal memory, cognitive efficiency, executive skills, processing speed, and working memory. The longitudinal and cross-sectional neurocognitive differences observed between nonsmoking and smoking ALC remained significant after covarying for group differences in education, estimated premorbid intelligence alcohol consumption, and other potentially confounding variables. In smoking ALC, greater smoking severity was inversely related to longitudinal improvement on multiple neurocognitive measures.
These preliminary results suggest that chronic smoking may modulate neurocognitive recovery in abstinent alcoholic patients. More generally, chronic smoking may impact neurocognition in other conditions where is it a prevalent behavior.
在北美，约50%至90%寻求酒精成瘾治疗的人是长期吸烟者。越来越多的证据表明，长期吸烟的人表现出一种神经认知功能障碍模式，类似于在酒精成瘾患者中观察到的模式。然而，先前调查戒酒酒精成瘾患者神经认知恢复情况的研究并未具体考虑长期吸烟的潜在影响。
本研究全面比较了13名非吸烟戒酒酒精成瘾患者（ALC）和12名仍在积极吸烟的ALC在戒酒6至9个月期间的纵向神经认知变化。将酒精成瘾组的神经认知表现与非吸烟轻度饮酒对照组（非吸烟LD）进行比较。
在认知效率、执行技能、视觉空间技能和工作记忆方面的测量中，非吸烟ALC比吸烟ALC表现出显著更大程度的纵向改善。非吸烟ALC和吸烟ALC在听觉言语学习、听觉言语记忆和处理速度方面均表现出同等程度的改善。非吸烟LD的神经认知随时间无显著变化。在戒酒6至9个月时的横断面比较中，非吸烟ALC在听觉言语学习、听觉言语记忆、认知效率、执行技能、处理速度和工作记忆方面优于吸烟ALC。在对教育程度、估计的病前智力、酒精摄入量和其他潜在混杂变量的组间差异进行协变量调整后，非吸烟和吸烟ALC之间观察到的纵向和横断面神经认知差异仍然显著。在吸烟ALC中，吸烟严重程度越高，在多项神经认知测量中的纵向改善越差。
这些初步结果表明，长期吸烟可能会调节戒酒酒精成瘾患者的神经认知恢复。更普遍地说，长期吸烟可能会影响其他普遍存在吸烟行为的情况下的神经认知。
