Ramesh Divya, Keyser-Marcus Lori A, Ma Liangsuo, Schmitz Joy M, Lane Scott D, Marwitz Jennifer H, Kreutzer Jeffrey S, Moeller Frederick Gerard
Department of Pharmacology Toxicology, Virginia Commonwealth University, Richmond, Virginia; Institute for Drug & Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia.
Am J Addict. 2015 Jun;24(4):341-7. doi: 10.1111/ajad.12192. Epub 2015 Feb 6.
There is a high prevalence of traumatic brain injury (TBI) among those with substance dependence. However, TBI often remains undiagnosed in these individuals, due to lack of routine screening in substance use treatment settings or due to overlap in some of the cognitive sequelae (eg impulsivity, disinhibition) of TBI and cocaine dependence.
The prevalence of self-reported mild to moderate TBI in a group of cocaine-dependent (n = 95) and a group of healthy volunteers (n = 75) enrolled at the same facility was assessed. Additionally, the relationship between TBI and clinically relevant correlates, including impulsivity, cocaine use history, and treatment outcome in the cocaine-dependent group was also examined.
A higher proportion of individuals with cocaine dependence (29.5%) reported having suffered a TBI in their lifetime compared to controls (8%) on a Closed Head Injury scale. Among cocaine users, the average age of sustaining TBI was significantly lower than the age of initiating cocaine use. Presence of TBI was not associated with higher impulsivity on the Barratt Impulsiveness Scale-11 or self-reported years of cocaine use. No differences were noted on treatment outcome for cocaine dependence as measured by treatment effectiveness scores (TES) between cocaine users with TBI and their non-TBI counterparts.
These results are the first to highlight the high prevalence of TBI among individuals with cocaine dependence. This study underscores the possible role of TBI history as a risk factor for onset of cocaine use, however, more research is needed to determine the impact of co-morbid TBI as a complicating factor in the substance abuse treatment setting.
物质依赖者中创伤性脑损伤（TBI）的患病率很高。然而，由于物质使用治疗环境中缺乏常规筛查，或者由于TBI和可卡因依赖的一些认知后遗症（如冲动、去抑制）存在重叠，TBI在这些个体中常常未被诊断出来。
评估了在同一机构招募的一组可卡因依赖者（n = 95）和一组健康志愿者（n = 75）中自我报告的轻度至中度TBI的患病率。此外，还研究了TBI与临床相关因素之间的关系，包括冲动性、可卡因使用史以及可卡因依赖组的治疗结果。
在闭合性颅脑损伤量表上，与对照组（8%）相比，可卡因依赖者中报告有过TBI病史的比例更高（29.5%）。在可卡因使用者中，遭受TBI的平均年龄显著低于开始使用可卡因的年龄。TBI的存在与Barratt冲动性量表-11上较高的冲动性或自我报告的可卡因使用年限无关。根据治疗效果评分（TES）衡量，有TBI的可卡因使用者和无TBI的可卡因使用者在可卡因依赖治疗结果方面没有差异。
这些结果首次突出了可卡因依赖者中TBI的高患病率。本研究强调了TBI病史作为可卡因使用起始风险因素的可能作用，然而，需要更多研究来确定共病TBI作为物质滥用治疗环境中一个复杂因素的影响。
