Lorea Iñaki, Fernández-Montalvo Javier, Tirapu-Ustárroz Javier, Landa Natalia, López-Goñi José J
Fundacion Argibide, Pamplona, España.
Rev Neurol. 2010 Oct 1;51(7):412-26.
Chronic use of cocaine has been associated with a wide range of neuropsychological deficits affecting attention, memory, learning and executive functions. However, it has not been found a unique profile of impairment associated with cocaine addiction.
To review the studies about neurocognitive performance in cocaine addicted patients, with special attention to the research method used.
A great diversity in the research methodology of cognitive deficits associated with cocaine addiction has been used. These differences make difficult to compare results and obtain a clear profile of neuropsychological deficits. Even though, most of studies find neuropsychological deficits (mainly of medium size) associated with cocaine addiction. These problems are usually related to attention, verbal and visual memory and executive functions (working memory, mental flexibility, verbal fluency, inhibition and decision making). Moreover, in some studies a dissociated profile of cognitive performance has been found.
Chronic use of cocaine is associated with worse cognitive performance. Therefore, the cognitive assessment of cocaine addicted patients can improve the understanding of the nature of the difficulties that these patients exhibit in everyday life and also can help to guide the treatment. Probably, the presence of subtle cognitive changes has important consequences on the behaviour of these patients. However, neuropsychological performance is not usually assessed in the assessment guidelines of this disorder. Therefore, it is proposed to include a neuropsychological assessment for initial assessment of cocaine addicted patients, as well as to tailor treatment to the found deficit.
长期使用可卡因与一系列影响注意力、记忆力、学习能力和执行功能的神经心理缺陷有关。然而,尚未发现与可卡因成瘾相关的独特损伤特征。
回顾关于可卡因成瘾患者神经认知表现的研究,特别关注所使用的研究方法。
在与可卡因成瘾相关的认知缺陷研究方法上存在很大差异。这些差异使得难以比较结果并获得清晰的神经心理缺陷特征。尽管如此,大多数研究发现与可卡因成瘾相关的神经心理缺陷(主要为中等程度)。这些问题通常与注意力、言语和视觉记忆以及执行功能(工作记忆、心理灵活性、言语流畅性、抑制和决策)有关。此外,在一些研究中发现了认知表现的解离特征。
长期使用可卡因与较差的认知表现相关。因此,对可卡因成瘾患者的认知评估可以增进对这些患者在日常生活中所表现出困难的本质的理解,也有助于指导治疗。可能,细微认知变化的存在对这些患者的行为有重要影响。然而,在这种疾病的评估指南中通常不评估神经心理表现。因此,建议对可卡因成瘾患者进行初步评估时纳入神经心理评估,并根据所发现的缺陷调整治疗方案。