Durazzo Timothy C, Rothlind Johannes C, Gazdzinski Stefan, Meyerhoff Dieter J
Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA 94121, USA.
Alcohol. 2008 Sep;42(6):439-49. doi: 10.1016/j.alcohol.2008.06.001.
Co-morbidities that commonly accompany those afflicted with an alcohol use disorder (AUD) may promote variability in the pattern and magnitude of neurocognitive abnormalities demonstrated. The goal of this study was to investigate the influence of several common co-morbid medical conditions (primarily hypertension and hepatitis C), psychiatric (primarily unipolar mood and anxiety disorders), and substance use (primarily psychostimulant and cannabis) disorders, and chronic cigarette smoking on the neurocognitive functioning in short-term abstinent, treatment-seeking individuals with AUD. Seventy-five alcohol-dependent participants (ALC; 51+/-9 years of age; three females) completed comprehensive neurocognitive testing after approximately 1 month of abstinence. Multivariate multiple linear regression evaluated the relationships among neurocognitive variables and medical conditions, psychiatric, and substance-use disorders, controlling for sociodemographic factors. Sixty-four percent of ALC had at least one medical, psychiatric, or substance-abuse co-morbidity (excluding smoking). Smoking status (smoker or nonsmoker) and age were significant independent predictors of cognitive efficiency, general intelligence, postural stability, processing speed, and visuospatial memory after age-normed adjustment and control for estimated pre-morbid verbal intelligence, education, alcohol consumption, and medical, psychiatric, and substance-misuse co-morbidities. Results indicated that chronic smoking accounted for a significant portion of the variance in the neurocognitive performance of this middle-aged AUD cohort. The age-related findings for ALC suggest that alcohol dependence, per se, was associated with diminished neurocognitive functioning with increasing age. The study of participants who demonstrate common co-morbidities observed in AUD is necessary to fully understand how AUD, as a clinical syndrome, affects neurocognition, brain neurobiology, and their changes with extended abstinence.
通常伴随酒精使用障碍(AUD)患者的共病可能会导致所表现出的神经认知异常模式和程度出现差异。本研究的目的是调查几种常见的共病情况(主要是高血压和丙型肝炎)、精神疾病(主要是单相情绪和焦虑障碍)、物质使用(主要是精神兴奋剂和大麻)障碍以及长期吸烟对短期戒酒、寻求治疗的AUD患者神经认知功能的影响。75名酒精依赖参与者(ALC;年龄51±9岁;3名女性)在戒酒约1个月后完成了全面的神经认知测试。多变量多元线性回归评估了神经认知变量与医疗状况、精神疾病和物质使用障碍之间的关系,并对社会人口统计学因素进行了控制。64%的ALC至少有一种医疗、精神或物质滥用共病(不包括吸烟)。在对预估的病前言语智力、教育程度、酒精摄入量以及医疗、精神和物质滥用共病进行年龄标准化调整和控制后,吸烟状态(吸烟者或非吸烟者)和年龄是认知效率、一般智力、姿势稳定性、处理速度和视觉空间记忆的显著独立预测因素。结果表明,长期吸烟在这个中年AUD队列的神经认知表现差异中占很大比例。ALC与年龄相关的研究结果表明,酒精依赖本身与随着年龄增长神经认知功能下降有关。对表现出AUD中常见共病的参与者进行研究,对于全面了解AUD作为一种临床综合征如何影响神经认知、脑神经生物学以及它们随着长期戒酒的变化是必要的。