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美沙酮维持治疗期间的反应抑制和运动速度:治疗持续时间、剂量和睡眠剥夺的影响。

Response inhibition and psychomotor speed during methadone maintenance: impact of treatment duration, dose, and sleep deprivation.

机构信息

Behavioral Psychopharmacology Research Lab, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.

出版信息

Drug Alcohol Depend. 2012 Sep 1;125(1-2):132-9. doi: 10.1016/j.drugalcdep.2012.04.004. Epub 2012 Apr 30.

Abstract

BACKGROUND

In opiate-dependent individuals, abstinence results in deficits in cognitive functioning, which may be exacerbated by medication-associated sleep disruption.

METHOD

To assess cognitive function and the influence of sleep deprivation (SD), 14 healthy control (HC) and 22 methadone maintained (MM) participants completed the continuous performance task (CPT) after a baseline night, a night of total SD, and two recovery sleep nights. The digit symbol substitution task (DSST) was administered at bedtime and in the morning. Secondary analyses separated MM participants into short- (< 12 months; n=8) and long-term (≥ 12 months; n=14) treatment duration groups, and into low- (< 80 mg; n=9) and high-dose (≥ 80 mg; n=13) groups.

RESULTS

Linear mixed model ANOVAs revealed that there was no effect of SD. Across all days MM participants had more errors of omission, fewer correct responses, and slower reaction times (RTs) on the CPT, and fewer accurate substitutions on the evening and morning DSST. Short-term MM participants exhibited slower RTs on the CPT, and fewer correct substitutions on the evening DSST compared to long-term MM participants. Low-dose MM participants had slower RTs on the CPT than HCs and high-dose MM participants.

CONCLUSION

These data demonstrate that methadone-maintained individuals exhibit poorer performance on tasks of psychomotor speed and selective attention/impulsivity, but with longer-term treatment, performance appears to return toward control levels. Furthermore, while one day of SD was enough to alter subjective reports of sleep quality, cognitive function may be more resilient.

摘要

背景

在阿片类药物依赖个体中,戒断会导致认知功能缺陷,而药物相关的睡眠中断可能会使这种缺陷加剧。

方法

为了评估认知功能和睡眠剥夺(SD)的影响,14 名健康对照(HC)和 22 名美沙酮维持(MM)参与者在基线夜、完全 SD 夜和两个恢复睡眠夜后完成连续性能任务(CPT)。数字符号替代任务(DSST)在睡前和早上进行。二次分析将 MM 参与者分为短期(<12 个月;n=8)和长期(≥12 个月;n=14)治疗持续时间组,以及低剂量(<80mg;n=9)和高剂量(≥80mg;n=13)组。

结果

线性混合模型 ANOVA 显示 SD 没有影响。在所有日子里,MM 参与者在 CPT 上的漏报错误更多、正确反应更少、反应时间(RT)更慢,在晚上和早上的 DSST 上的准确替代更少。与长期 MM 参与者相比,短期 MM 参与者在 CPT 上的 RT 更慢,在晚上的 DSST 上的正确替代更少。与 HC 和高剂量 MM 参与者相比,低剂量 MM 参与者在 CPT 上的 RT 更慢。

结论

这些数据表明,美沙酮维持个体在精神运动速度和选择性注意/冲动性任务上的表现较差,但随着治疗时间的延长,表现似乎恢复到对照水平。此外,尽管一天的 SD 足以改变睡眠质量的主观报告,但认知功能可能更具弹性。

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