Clinical of Psychiatry, Clinical Center Vojvodina, Novi Sad, Serbia.
Eur Rev Med Pharmacol Sci. 2012 Aug;16(8):1052-60.
Alcohol delirium tremens suggests dysfunction of numerous brain regions. Several Authors suggest that alcohol and withdrawal from alcohol could cause neurotoxic lesions in the frontal lobe and thereby affect cognitive function. However, it is not that well known whether the consequences of the damage following delirium are only quantitative or qualitative.
Thirty alcohol-dependent patients after alcohol delirium (ADT-n1 = 30), and 30 alcohol-dependent patients without alcohol delirium (ALC-n2=30) were compared with neuropsychological test-battery. [(Wechsler Bellevue Intelligence Scale - WB form I, Wechsler memory scale and Rey Auditory Verbal Learning Test (RAVLT)]. Examinees were selected as equivalent pairs, in such a manner that they were of approximately same age, i.e. age difference was 0-5 years, they were of the same education level, and difference in the duration of drinking was not more than 3 years.
In the group of ADT patients, IQ was 97.53, while it is 109.53 for ALC patients. Mental deterioration of the examined group is 40, and in the control group 13. Group of ADT patients had significantly lower achievements on subtests: arithmetic, block design and digit symbol. ADT patients' average memory quotient (MQ) is 81.8, which is three standard deviations lower compared to ALC patients (MQ 102.2) and standard values, according to Wechsler. In the first repetition of the series of 15 words RAVLT, is no difference (t-test=1.88; p > 0.05), while the difference in other repetitions is significant. Difference is also statistically significant regarding recollection after 30 minutes (t-test=3.66; p < 0.05).
There is qualitative difference in cognitive deficiencies in alcoholics with delirium tremens and those with no alcohol delirium, while the predominant pathology of the cognitive-amnestic deficiency is in compliance with the dysfunction of the prefrontal lobe. Following alcohol delirium, verbal memory disorders occur within the intellectual decrease and attention disorder in general.
酒精戒断性震颤谵妄表明多个脑区功能障碍。有几位作者认为,酒精和酒精戒断可能导致额叶的神经毒性损伤,从而影响认知功能。然而,尚不清楚谵妄后损伤的后果仅是数量上的还是质量上的。
将 30 例酒精戒断性震颤谵妄患者(ADT-n1=30)和 30 例无酒精戒断性震颤谵妄患者(ALC-n2=30)与神经心理学测试组进行比较。[(韦氏贝鲁瓦智力测验- WB 形式 I、韦氏记忆量表和 Rey 听觉言语学习测验(RAVLT))]。被试者以配对的方式选择,即年龄相差 0-5 岁,教育程度相同,饮酒时间相差不超过 3 年。
ADT 组的智商为 97.53,而 ALC 组的智商为 109.53。被检查组的智力下降 40%,而对照组为 13%。ADT 组在算术、积木设计和数字符号等子测验中的成绩明显较低。ADT 患者的平均记忆商(MQ)为 81.8,比 ALC 患者(MQ 102.2)和韦氏标准低三个标准差。在 RAVLT 系列 15 个单词的第一次重复中,没有差异(t 检验=1.88;p>0.05),而其他重复的差异是显著的。30 分钟后回忆的差异也具有统计学意义(t 检验=3.66;p<0.05)。
在有震颤谵妄的酒精中毒患者和无震颤谵妄的酒精中毒患者中,认知缺陷存在质的差异,而认知-健忘缺陷的主要病理变化与额叶功能障碍一致。酒精戒断性震颤谵妄后,言语记忆障碍发生在智力下降和注意力障碍的情况下。