Department of Addictive Behaviour and Addiction Medicine/Department of Clinical and Cognitive Neuroscience, Central Institute of Mental Health,University of Heidelberg, Mannheim, Germany.
Alcohol Alcohol. 2010 Nov-Dec;45(6):541-7. doi: 10.1093/alcalc/agq065. Epub 2010 Sep 29.
Several authors suggest that withdrawal from alcohol could cause neurotoxic lesions in the frontal lobe and thereby affect cognitive function. In line with this, previous studies have demonstrated greater cognitive impairment of alcohol-dependent patients with two or more previous detoxifications (Hi-detox) compared with patients with less than two detoxifications (Lo-detox). The aim of the present study was to investigate whether repeated withdrawal from alcohol affects recovery of cognitive function and is related to relapse.
Forty-eight alcohol-dependent patients (Hi-detox: n = 31, Lo-detox: n = 17) and 36 healthy controls underwent a comprehensive neuropsychological test-battery. Patients were tested after completion of detoxification (T1) and 3 (T2, n = 35) and 6 (T3, n = 28) months after discharge. Healthy controls were tested at T1 (n = 36) and T2 (n = 16). Drinking behaviour was assessed at all times.
Patients performed significantly worse than controls at T1 as well as T2 with regard to attention/executive function. Recovery of attention/executive function was observed within the second 3 months after discharge, but the Hi-detox group performed worse than the Lo-detox group. No association with relapse was observed.
This study provides first evidence, that repeated withdrawal from alcohol might be associated with reduced brain plasticity as indicated by a delay of recovery from impairment of attention/executive function. However, little evidence was found for a direct influence of cognitive impairment on treatment success.
一些作者认为，戒酒可能会在前额叶造成神经毒性损伤，从而影响认知功能。基于这一点，先前的研究表明，与少于两次戒酒的患者（Lo-detox）相比，有两次或两次以上戒酒史的酒精依赖患者（Hi-detox）的认知障碍更为严重。本研究旨在探讨反复戒酒是否会影响认知功能的恢复，以及是否与复发有关。
48 名酒精依赖患者（Hi-detox：n=31，Lo-detox：n=17）和 36 名健康对照者接受了全面的神经心理学测试。患者在戒酒后（T1）以及出院后 3 个月（T2，n=35）和 6 个月（T3，n=28）进行测试。健康对照组在 T1（n=36）和 T2（n=16）进行测试。在所有时间点都评估了饮酒行为。
患者在 T1 和 T2 时的注意力/执行功能方面均明显逊于对照组。出院后第二个 3 个月内观察到注意力/执行功能的恢复，但 Hi-detox 组的表现不如 Lo-detox 组。未观察到与复发有关的情况。
本研究首次提供了证据，表明反复戒酒可能与大脑可塑性降低有关，这表明注意力/执行功能损伤的恢复延迟。然而，几乎没有证据表明认知障碍对治疗成功有直接影响。
