Madoz-Gúrpide Agustín, Ochoa-Mangado Enriqueta
Centro de Salud Mental San Blas, Madrid, Espana.
Rev Neurol. 2012 Feb 16;54(4):199-208.
In the past, various studies have related chronic cocaine use to diverse types of neuropsychological impairment. However, the majority of these studies offer partial results using batteries of tests of little ecological weight.
To investigate neuropsychological impairment (and of executive functions in particular) amongst severe chronic cocaine users, measured by means of more ecological tests and in a more global manner, taking confounding factors into account, such as age, years of schooling, gender, race, opioid dependence and alcohol consumption.
We performed an observational study, comparing the cocaine dependence group (n = 24) with a non-cocaine use control group (n = 27).
The principal results revealed significant differences in the direct and reverse digit span tests (p = 0.008 and p < 0.001 respectively), and in the Cards Test (p < 0.001). They also showed a significance result in the Zoo Map Test (p = 0.001), and in different measurements but not in all forming part of the Wisconsin test (number of correct responses and number of errors).
These results confirm that the chronic use of cocaine per se causes neuropsychological impairment that is manifested in classical and ecologically-valid tests. This impairment may influence patients' functionality and prognosis, and also therapeutic failure.
过去,各种研究已将长期使用可卡因与多种类型的神经心理损伤联系起来。然而,这些研究大多使用生态效度较低的测试组合得出部分结果。
通过更具生态效度的测试并以更全面的方式,研究重度慢性可卡因使用者的神经心理损伤(尤其是执行功能损伤),同时考虑年龄、受教育年限、性别、种族、阿片类药物依赖和饮酒等混杂因素。
我们进行了一项观察性研究,将可卡因依赖组(n = 24)与非可卡因使用对照组(n = 27)进行比较。
主要结果显示,在顺背和倒背数字广度测试(分别为p = 0.008和p < 0.001)以及卡片测试(p < 0.001)中存在显著差异。在动物园地图测试(p = 0.001)以及威斯康星测试的不同测量项目(正确反应数和错误数)中也显示出显著结果,但并非所有项目都如此。
这些结果证实,长期使用可卡因本身会导致神经心理损伤,这在经典且具有生态效度的测试中有所体现。这种损伤可能会影响患者的功能和预后,以及治疗效果。