Departamento de Clínica Médica, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
Alcohol Alcohol. 2009 Sep-Oct;44(5):449-57. doi: 10.1093/alcalc/agp043. Epub 2009 Aug 8.
This study examined the frontal lobe cognitive function and the mental state among patients with different types of alcohol dependence according to Lesch's typology.
The frontal assessment battery (FAB) and the mini-mental status examination (MMSE) were given to 170 patients with alcoholism from a Brazilian outpatient service classified by Lesch's typology and to 40 non-alcoholic controls matched for age, gender, socio-demographic characteristics and education.
Of the alcoholic sample, 21.2% were classified as Type I, 29.4% as Type II, 28.8% as Type III and 20.6% as Type IV. Alcoholics showed significantly lower overall scores on the MMSE and the FAB as compared to non-alcoholic subjects. Type IV alcoholics had lower MMSE and FAB overall scores as compared to non-alcoholic controls and also to all other types of alcoholic subjects. However, Type II and III subjects with alcoholism also had lower overall FAB scores, but not overall MMSE scores, as compared to non-alcoholic controls. The FAB subsets of motor programming, sensitivity to interference and inhibitory control were significantly reduced in Types II, III and IV alcoholics as compared to non-alcoholic subjects, but only motor programming remained impaired in Type IV alcoholics with preserved mental function.
Executive dysfunctions in alcohol dependence seem to vary depending upon the type of alcoholism. Therefore, the determination of clinical type of alcohol dependence by applying Lesch's typology, along with brief mental state and frontal function examinations, is of clinical relevance in the examination of alcoholics and provides significant clues for more directed forms of alcohol dependence treatment.
本研究根据 Lesch 分类法，检查了不同类型酒精依赖患者的额叶认知功能和精神状态。
对来自巴西门诊服务的 170 名酒精中毒患者（根据 Lesch 分类法进行分类）和 40 名非酒精对照者（年龄、性别、社会人口统计学特征和教育程度相匹配）进行了额叶评估量表（FAB）和简易精神状态检查（MMSE）。
在酒精样本中，21.2%为 I 型，29.4%为 II 型，28.8%为 III 型，20.6%为 IV 型。与非酒精对照组相比，酒精组的 MMSE 和 FAB 总分明显较低。与非酒精对照组和所有其他类型的酒精组相比，IV 型酒精组的 MMSE 和 FAB 总分均较低。然而，II 型和 III 型酒精组的 FAB 总分也较低，但 MMSE 总分则不然。与非酒精对照组相比，II 型、III 型和 IV 型酒精组的运动编程、对干扰的敏感性和抑制控制的 FAB 子集明显降低，但只有在保留精神功能的 IV 型酒精中毒者中，运动编程仍然受损。
酒精依赖中的执行功能障碍似乎因酒精依赖的类型而异。因此，通过应用 Lesch 分类法确定临床类型的酒精依赖，结合简短的精神状态和额叶功能检查，对酒精依赖患者的检查具有临床相关性，并为更有针对性的酒精依赖治疗形式提供了重要线索。
