Novadic-Kentron Addiction Care, Vught, The Netherlands.
Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, The Netherlands.
Eur Addict Res. 2022;28(5):350-357. doi: 10.1159/000525507. Epub 2022 Jul 19.
The recreational use of gamma hydroxybutyrate (GHB) is associated with frequent overdoses, coma and the risk of developing GHB use disorder (GUD). Several studies suggest negative effects of GHB use or related comas on cognition. Since relapse rates are high in GUD and cognitive impairment has been associated with relapse in other substance use disorders, we aimed to (1) investigate the prevalence of cognitive impairment before and after detoxification, (2) analyse the relationship between GHB use, comas, and cognitive impairment, and (3) explore the association between cognitive impairment and relapse after detoxification in GUD patients.
In these secondary analyses of a prospective cohort study, a consecutive series of patients with GUD (n = 103) admitted for detoxification were recruited at six addiction care facilities in the Netherlands. The Montreal Cognitive Assessment (MoCA) was used to screen for cognitive impairments before and after detoxification. The follow-up duration for the assessment of relapse in GHB use was 3 months.
A substantial number of patients with GUD screened positive for cognitive impairment before (56.3%) and after (30.6%) detoxification. Impairment on the MoCA memory domain was most frequent (58.8%). Cognitive impairment was not related to the severity of GUD or number of GHB-induced comas. Logistic regression analysis showed that only the memory score independently predicted relapse.
Cognitive impairment seems highly prevalent among patients with GUD, possibly related to the risk of relapse. The absence of a relationship between the severity of GUD, level of GHB use, the number of GHB-induced comas, and cognitive impairment suggest that other factors may also contribute to the observed cognitive impairment.
γ-羟基丁酸（GHB）的消遣性使用与频繁的药物过量、昏迷以及发展为 GHB 使用障碍（GUD）的风险相关。有几项研究表明 GHB 使用或相关昏迷对认知功能有负面影响。由于 GUD 的复发率较高，并且认知障碍与其他物质使用障碍的复发有关，我们旨在：（1）调查戒断前后认知障碍的患病率；（2）分析 GHB 使用、昏迷与认知障碍之间的关系；（3）探索 GUD 患者戒断后认知障碍与复发之间的关联。
在这项前瞻性队列研究的二次分析中，我们招募了荷兰六个成瘾治疗机构连续收治的 103 名 GUD 患者，这些患者因戒断而入院。蒙特利尔认知评估（MoCA）用于筛选戒断前后的认知障碍。GHB 使用复发的随访时间为 3 个月。
大量 GUD 患者在戒断前后（分别为 56.3%和 30.6%）的认知障碍筛查中呈阳性。MoCA 记忆域的损害最为常见（58.8%）。认知障碍与 GUD 的严重程度或 GHB 诱导的昏迷次数无关。逻辑回归分析表明，只有记忆评分独立预测复发。
认知障碍在 GUD 患者中似乎非常普遍，这可能与复发风险有关。GUD 的严重程度、GHB 使用水平、GHB 诱导的昏迷次数与认知障碍之间缺乏关系表明，其他因素也可能导致观察到的认知障碍。
