Loeber Sabine, Duka Theodora, Welzel Helga, Nakovics Helmut, Heinz Andreas, Flor Herta, Mann Karl
Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, 68159 Mannheim, Germany.
Alcohol Alcohol. 2009 Jul-Aug;44(4):372-81. doi: 10.1093/alcalc/agp030. Epub 2009 Jun 1.
In the present study, the effect of previous detoxifications on prefrontal function and decision making was examined in alcohol-dependent patients. Further, we examined whether the length of abstinence affects cognitive function.
Forty-eight alcohol-dependent patients were recruited from an inpatient detoxification treatment facility and cognitive function was compared to a control group of 36 healthy controls. The patient population was then divided into a group of patients with less than two previous detoxifications (LO-detox group, n = 27) and a group of patients with two or more previous detoxifications (HI-detox group, n = 21) and cognitive function was compared. In addition, cognitive function of recently (i.e. less than 16 days; median split) and longer abstinent patients was compared. We assessed prefrontal function, memory function and intelligence.
Alcoholics, when compared to healthy controls, performed worse with regard to the performance index Attention/Executive function. Cognitive impairment in these tasks was pronounced in recently abstinent patients. We found no significant differences between HI-detox and LO-detox patients with regard to the Attention/Executive function. However, in the IOWA gambling Task, the HI-detox group seemed to be less able to learn to choose cards from the more advantageous decks over time.
Our results provide additional evidence for cognitive impairment of alcohol-dependent patients with regard to tasks sensitive to frontal lobe function and underline the importance of abstinence for these impairments to recover. We found only little evidence for the impairing effects of repeated withdrawal on prefrontal function and we suggest that executive function is affected earlier in dependence.
在本研究中，我们考察了既往戒酒对酒精依赖患者前额叶功能和决策的影响。此外，我们还研究了戒酒时长是否会影响认知功能。
从一家住院戒酒治疗机构招募了48名酒精依赖患者，并将其认知功能与36名健康对照者组成的对照组进行比较。然后，将患者群体分为既往戒酒次数少于两次的患者组（低戒酒组，n = 27）和既往戒酒次数为两次或更多的患者组（高戒酒组，n = 21），并比较两组的认知功能。此外，还比较了近期（即少于16天；中位数分割）戒酒和长期戒酒患者的认知功能。我们评估了前额叶功能、记忆功能和智力。
与健康对照者相比，酒精依赖患者在注意力/执行功能表现指数方面表现更差。在这些任务中，近期戒酒的患者认知障碍更为明显。在注意力/执行功能方面，我们发现高戒酒组和低戒酒组患者之间没有显著差异。然而，在爱荷华赌博任务中，随着时间的推移，高戒酒组似乎不太能够学会从更有利的牌组中选择纸牌。
我们的结果为酒精依赖患者在对额叶功能敏感的任务方面存在认知障碍提供了更多证据，并强调了戒酒对于这些障碍恢复的重要性。我们仅发现少量证据表明反复戒酒会对前额叶功能产生损害作用，并且我们认为执行功能在成瘾早期就受到了影响。
