Centre de Recherche Fernand-Seguin, Department of Psychiatry, Faculty of Medicine, University of Montreal, Canada.
Addict Biol. 2013 Mar;18(2):203-13. doi: 10.1111/j.1369-1600.2011.00418.x. Epub 2012 Jan 20.
The cognitive repercussions of alcohol dependence are well documented. However, the literature remains somewhat ambiguous with respect to which distinct cognitive functions are more susceptible to impairment in alcoholism and to how duration of abstinence affects cognitive recovery. Some theories claim alcohol negatively affects specific cognitive functions, while others assert that deficits are more diffuse in nature. This is the first meta-analysis to examine cognition in alcohol abuse/dependence and the duration of abstinence necessary to achieve cognitive recovery. A literature search yielded 62 studies that assessed cognitive dysfunction among alcoholics. Effect size estimates were calculated using the Comprehensive Meta-Analysis V2, for the following 12 cognitive domains: intelligence quotient, verbal fluency/language, speed of processing, working memory, attention, problem solving/executive functions, inhibition/impulsivity, verbal learning, verbal memory, visual learning, visual memory and visuospatial abilities. Within these 12 domains, three effect size estimates were calculated based on abstinence duration. The three groups were partitioned into short- (< 1 month), intermediate- (2 to 12 months) and long- (> 1 year) term abstinence. Findings revealed moderate impairment across 11 cognitive domains during short-term abstinence, with moderate impairment across 10 domains during intermediate term abstinence. Small effect size estimates were found for long-term abstinence. These results suggest significant impairment across multiple cognitive functions remains stable during the first year of abstinence from alcohol. Generally, dysfunction abates by 1 year of sobriety. These findings support the diffuse brain hypothesis and suggest that cognitive dysfunction may linger for up to an average of 1 year post-detoxification from alcohol.
酒精依赖的认知后果已有充分记录。然而，关于哪些特定认知功能更容易受到酒精中毒的损害以及禁欲时间如何影响认知恢复，文献仍然存在一些模糊性。一些理论声称酒精会对特定的认知功能产生负面影响，而另一些理论则认为缺陷的性质更为弥散。这是首次对酒精滥用/依赖和实现认知恢复所需的禁欲时间进行的荟萃分析。文献检索产生了 62 项评估酗酒者认知功能障碍的研究。使用 Comprehensive Meta-Analysis V2 计算了以下 12 个认知领域的效应大小估计值：智商、言语流畅性/语言、处理速度、工作记忆、注意力、解决问题/执行功能、抑制/冲动、言语学习、言语记忆、视觉学习、视觉记忆和视空间能力。在这 12 个领域中，根据禁欲时间计算了三个效应大小估计值。将这三组分为短期（<1 个月）、中期（2 至 12 个月）和长期（>1 年）禁欲。研究结果表明，在短期禁欲期间，11 个认知领域存在中度损害，在中期禁欲期间，10 个领域存在中度损害。长期禁欲的效果大小估计值较小。这些结果表明，在戒酒的第一年，多个认知功能的严重损害仍然稳定。通常，功能障碍在戒酒 1 年后会减轻。这些发现支持弥散性脑假说，并表明认知功能障碍可能在酒精解毒后平均持续长达 1 年。
