Federico Angela, Lugoboni Fabio, Mantovani Elisa, Martini Alice, Morbioli Laura, Casari Rebecca, Faccini Marco, Tamburin Stefano
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Department of Medicine, Addiction Medicine Unit, Verona University Hospital, Verona, Italy.
Front Neurosci. 2020 Jul 21;14:747. doi: 10.3389/fnins.2020.00747. eCollection 2020.
High-dose benzodiazepines (BZDs) abuse has been documented to cause multidomain cognitive dysfunction. We explored whether cognitive abnormalities to high-dose BZD abuse might be reversed by detoxification with slow subcutaneous infusion of flumazenil.
We recruited 96 patients consecutively admitted to the Department of Internal Medicine, Addiction Medicine Unit, Verona University Hospital, Italy for detoxification from high-dose BZD dependence. After selection for inclusion and exclusion criteria, 50 patients (23 men, 27 women; age 42.7 ± 10.3 years) were included. They underwent a comprehensive neuropsychological battery to explore verbal memory, visuospatial memory, working memory, attention, and executive functions 28-30 days prior to admission for detoxification (T0) and at the end of detoxification, i.e., 7 days after admission (T1). A group of 50 healthy adults (24 men, 26 women; mean age 44.5 ± 12.8 years) matched for age, sex, and education served as controls.
At T0, patients scored significantly worse than healthy controls in all the neuropsychological tests. Depression and anxiety scores were associated with impaired verbal memory at T0 in patients. T1-T0 comparison showed improved performances in all neuropsychological tests after the end of detoxification in patients.
We confirmed that all neuropsychological domains were significantly and profoundly impaired by high-dose BZD abuse and documented that cognitive abnormalities improved after detoxification with slow subcutaneous infusion of flumazenil.
有文献记载，高剂量苯二氮䓬类药物（BZD）滥用会导致多领域认知功能障碍。我们探讨了通过缓慢皮下输注氟马西尼进行解毒，高剂量BZD滥用所致的认知异常是否可以得到逆转。
我们连续招募了96名因高剂量BZD依赖而到意大利维罗纳大学医院内科成瘾医学科进行解毒治疗的患者。在根据纳入和排除标准进行筛选后，纳入了50名患者（23名男性，27名女性；年龄42.7±10.3岁）。他们在解毒治疗入院前28 - 30天（T0）以及解毒治疗结束时，即入院7天后（T1），接受了一套全面的神经心理学测试，以探究言语记忆、视觉空间记忆、工作记忆、注意力和执行功能。一组50名年龄、性别和教育程度相匹配的健康成年人（24名男性，26名女性；平均年龄44.5±12.8岁）作为对照。
在T0时，患者在所有神经心理学测试中的得分均显著低于健康对照组。患者在T0时的抑郁和焦虑评分与言语记忆受损有关。T1与T0的比较显示，患者解毒治疗结束后在所有神经心理学测试中的表现均有所改善。
我们证实，高剂量BZD滥用会显著且严重损害所有神经心理学领域，并证明通过缓慢皮下输注氟马西尼进行解毒后，认知异常有所改善。
