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长期戒酒之后酒精中毒中广泛存在的认知缺陷依然持续:一项使用标准化神经心理学评估工具的研究的最新荟萃分析

Widespread Cognitive Deficits in Alcoholism Persistent Following Prolonged Abstinence: An Updated Meta-analysis of Studies That Used Standardised Neuropsychological Assessment Tools.

作者信息

Crowe Simon F, Cammisuli Davide M, Stranks Elizabeth K

机构信息

School of Psychology and Public Health, La Trobe University, Victoria, Australia.

Department of Surgical, Medical, Molecular, and Critical Area Pathology, Pisa University Medical School, Pisa, Italy.

出版信息

Arch Clin Neuropsychol. 2019 Jan 24;35(1):31-45. doi: 10.1093/arclin/acy106.

Abstract

OBJECTIVE

This study presents an updated meta-analysis replicating the study of (Stavro, K., Pelletier, J., & Potvin, S. (2013). Widespread and sustained cognitive deficits in alcoholism: A meta-analysis. Addiction Biology, 18, 203-213. doi:10.1111/j.1369-1600.2011.00418.x) regarding the cognitive functioning of alcoholics as a function of time abstinent.

METHODS

A total of 34 studies (including a total of 2,786 participants) that met pre-determined inclusion and exclusion criteria were included in the analyses. The alcoholics were categorised into recently detoxified alcoholics (0-31 days sober), alcoholics 32-365 days sober and alcoholics >365 days sober consistent with the previous study. The current study employed more stringent control on the tests included in the analysis to include only those tasks described in contemporary neuropsychological test compendia. Forty-seven percent of the papers surveyed were not include in the previous meta-analysis.

RESULTS

The results indicated that there was a diffuse and pervasive pattern of cognitive deficit among recently detoxified alcoholics and that these deficits, particularly with regard to memory functioning, persisted even in longer term abstinent alcoholics. This was inconsistent with the prior meta-analysis which contended that significant cognitive recovery was possible after as little as 1 year.

CONCLUSION

The persisting cognitive deficits were noted across a wide range of cognitive functions, supporting the notion of a diffuse rather than a specific compromise of cognition in alcoholism following discontinuation, as measured using standardised neuropsychological tests. Limitations on the finding included the fact that it was a cross-sectional rather than a longitudinal analysis, was subject to heterogeneity of method, had low representation of females in the samples, and had fewer studies of long-term sober samples.

摘要

目的

本研究进行了一项更新的荟萃分析,重复了(斯塔夫罗、K.、佩尔蒂埃、J.和波廷、S.(2013年)。酗酒者广泛且持续的认知缺陷:一项荟萃分析。《成瘾生物学》,18,203 - 213。doi:10.1111/j.1369 - 1600.2011.00418.x)关于酗酒者认知功能随戒酒时间变化的研究。

方法

分析纳入了34项符合预先确定的纳入和排除标准的研究(共2786名参与者)。与之前的研究一致,酗酒者被分为近期戒酒的酗酒者(戒酒0 - 31天)、戒酒32 - 365天的酗酒者和戒酒超过365天的酗酒者。本研究对分析中纳入的测试进行了更严格的控制,仅纳入当代神经心理学测试手册中描述的那些任务。所调查的论文中有47%未纳入之前的荟萃分析。

结果

结果表明,近期戒酒的酗酒者存在广泛且普遍的认知缺陷模式,并且这些缺陷,尤其是在记忆功能方面,即使在长期戒酒的酗酒者中也持续存在。这与之前的荟萃分析不一致,之前的荟萃分析认为仅1年后就有可能实现显著的认知恢复。

结论

在广泛的认知功能中都发现了持续的认知缺陷,这支持了这样一种观点,即使用标准化神经心理学测试测量时,戒酒后酗酒者的认知损害是广泛的而非特定的。该研究结果的局限性包括它是横断面分析而非纵向分析,存在方法异质性,样本中女性代表性低,以及对长期戒酒样本的研究较少。

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