物质依赖后持续戒断后神经认知功能的恢复及其对治疗的影响。
Recovery of neurocognitive functions following sustained abstinence after substance dependence and implications for treatment.
机构信息
Addiction, Development, and Psychopathology (ADAPT) lab, Department of Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, The Netherlands; Amsterdam Institute for Addiction Research (AIAR), Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
Addiction, Development, and Psychopathology (ADAPT) lab, Department of Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, The Netherlands; Department of Developmental Psychology and Psychonomics, Utrecht University, Utrecht, The Netherlands.
出版信息
Clin Psychol Rev. 2014 Nov;34(7):531-50. doi: 10.1016/j.cpr.2014.08.002. Epub 2014 Aug 20.
BACKGROUND
Substance Use Disorders (SUDs) have been associated with impaired neurocognitive functioning, which may (partly) improve with sustained abstinence. New treatments are emerging, aimed at improving cognitive functions, and being tested. However, no integrated review is available regarding neurocognitive recovery following sustained abstinence.
OBJECTIVES
In this review, results from prospective studies on neurocognitive recovery using neuropsychological assessments before and after sustained abstinence from SUDs are summarized and discussed.
RESULTS
Thirty-five prospective studies were selected for this review, including twenty-two alcohol, three cannabis, four cocaine, three (meth)amphetamine, and three opioid studies. Results suggest that some cognitive functions (partially) recover after sustained abstinence, and that there are predictors of an unfavorable course such as poly-substance use and number of previous detoxifications.
CONCLUSIONS
Prospective studies indicate that sustained abstinence after SUDs generally results in (partial) neurocognitive recovery. However, a final answer regarding full recovery awaits prospective studies with neurocognitive assessments before, during, and after sustained abstinence from SUDs. New interventions that might enhance neurocognitive recovery after abstinence are discussed, including neurocognitive training, medication and neuromodulation.
背景
物质使用障碍（SUDs）与神经认知功能障碍有关，而这种障碍可能会随着持续戒断而部分改善。新的治疗方法正在出现，旨在改善认知功能并正在进行测试。然而，目前尚无关于 SUD 持续戒断后神经认知恢复的综合综述。
目的
在本综述中，总结并讨论了使用神经心理学评估在 SUD 持续戒断前后进行的前瞻性研究中关于神经认知恢复的结果。
结果
本综述共选择了 35 项前瞻性研究，包括 22 项酒精、3 项大麻、4 项可卡因、3 项（苯丙胺）安非他命和 3 项阿片类药物研究。结果表明，一些认知功能（部分）在持续戒断后会恢复，而一些不利病程的预测因素包括多物质使用和之前的解毒次数。
结论
前瞻性研究表明，SUD 后的持续戒断通常会导致（部分）神经认知恢复。然而，关于 SUD 持续戒断前后进行神经认知评估的前瞻性研究才能得出完全恢复的最终结论。讨论了可能增强戒断后神经认知恢复的新干预措施，包括神经认知训练、药物和神经调节。
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