Institute of Psychology, Erasmus University Rotterdam, Rotterdam, the Netherlands.
Biol Psychiatry. 2013 Apr 15;73(8):782-8. doi: 10.1016/j.biopsych.2012.12.016. Epub 2013 Jan 29.
Relapse after treatment is one of the most important problems in drug dependency. Several studies suggest that lack of cognitive control is one of the causes of relapse. In this study, a relative new electrophysiologic index of cognitive control, the error-related negativity, is investigated to examine its suitability as a predictor of relapse.
The error-related negativity was measured in 57 cocaine-dependent patients during their first week in detoxification treatment. Data from 49 participants were used to predict cocaine use at 3-month follow-up. Cocaine use at follow-up was measured by means of self-reported days of cocaine use in the last month verified by urine screening.
A multiple hierarchical regression model was used to examine the predictive value of the error-related negativity while controlling for addiction severity and self-reported craving in the week before treatment. The error-related negativity was the only significant predictor in the model and added 7.4% of explained variance to the control variables, resulting in a total of 33.4% explained variance in the prediction of days of cocaine use at follow-up.
A reduced error-related negativity measured during the first week of treatment was associated with more days of cocaine use at 3-month follow-up. Moreover, the error-related negativity was a stronger predictor of recent cocaine use than addiction severity and craving. These results suggest that underactive error-related brain activity might help to identify patients who are at risk of relapse as early as in the first week of detoxification treatment.
治疗后的复发是药物依赖的最重要问题之一。几项研究表明,认知控制不足是复发的原因之一。在这项研究中,我们研究了认知控制的一个相对较新的电生理指标——错误相关负波,以检验其作为复发预测因子的适用性。
在脱毒治疗的第一周,我们对 57 名可卡因依赖患者进行了错误相关负波测量。我们使用 49 名参与者的数据来预测他们在 3 个月随访时的可卡因使用情况。通过自我报告的上个月可卡因使用天数并结合尿液筛查来测量随访时的可卡因使用情况。
我们使用多元层次回归模型来检验错误相关负波在控制治疗前一周的成瘾严重程度和自我报告的渴求感的情况下的预测价值。错误相关负波是模型中唯一显著的预测因子,增加了 7.4%的可解释方差,使预测随访时可卡因使用天数的总可解释方差达到 33.4%。
在治疗的第一周测量到的错误相关负波减少与 3 个月随访时可卡因使用天数增加有关。此外,错误相关负波是近期可卡因使用的更强预测因子,优于成瘾严重程度和渴求感。这些结果表明,治疗早期脱毒治疗第一周的错误相关大脑活动减少可能有助于识别易复发的患者。