Staudt Jeroen, Kok Tim, de Haan Hein A, Walvoort Serge J W, Egger Jos I M
Tactus Addiction Treatment, Deventer, the Netherlands.
Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.
Neuropsychiatr Dis Treat. 2023 Sep 28;19:2039-2054. doi: 10.2147/NDT.S424017. eCollection 2023.
Studies have reported inconsistent results regarding the extent to which neurocognitive recovery occurs in abstinent patients with alcohol use disorder (AUD). In addition to abstinence, other factors may have influenced this process and contributed to the inconsistencies. This review examines the factors investigated in this regard and describes the possible influence of each factor based on the evidence collected.
PubMed was systematically searched for articles published between January 2000 and July 2023. Longitudinal humane studies investigating neurocognitive recovery in abstinent adult AUD patients were included. Studies with a cross-sectional design were excluded, as were studies that did not classify AUD according to the DSM-IV or 5 criteria, only examined binge use, did not report neuropsychological outcomes or duration of abstinence, or where neurological disorders were present.
Sixteen categories of factors were distinguished from 31 full-text articles. Consistent patterns were found, indicating an association between neurocognitive recovery and the "smoking" and 'brain volume" factors. Consistent patterns were also found indicating that there is no relationship with "quantities of alcohol used" and "education level." A similar consistent pattern was also found for "polysubstance use", "gender" and "verbal reading", but the number of studies is considered limited. The association with "age" is studied frequently but with inconsistent findings. The remaining eight factors were regarded as understudied.
The clearest patterns emerging from the evidence are a predominantly negative influence of smoking on neurocognitive recovery, associations between changes in brain area volume and neurocognitive recovery, and no association between neurocognitive recovery and the amount of alcohol consumed, as measured by self-report, nor with educational attainment. Future research on the understudied factors and factors with inconsistent evidence is needed, preferably through longitudinal designs with multiple assessment periods starting after at least two weeks of abstinence.
关于酒精使用障碍(AUD)戒酒患者神经认知恢复的程度,研究报告的结果并不一致。除戒酒外,其他因素可能也影响了这一过程,并导致了结果的不一致。本综述考察了这方面所研究的因素,并根据收集到的证据描述了每个因素可能产生的影响。
对PubMed进行系统检索,查找2000年1月至2023年7月发表的文章。纳入对成年AUD戒酒患者神经认知恢复情况进行调查的纵向人体研究。排除横断面设计的研究,以及未按照DSM-IV或5标准对AUD进行分类、仅研究暴饮、未报告神经心理学结果或戒酒持续时间,或存在神经系统疾病的研究。
从31篇全文文章中区分出16类因素。发现了一致的模式,表明神经认知恢复与“吸烟”和“脑容量”因素之间存在关联。还发现了一致的模式,表明与“饮酒量”和“教育水平”无关。对于“多物质使用”、“性别”和“言语阅读”也发现了类似的一致模式,但研究数量有限。对“年龄”的关联研究频繁,但结果不一致。其余8个因素被认为研究不足。
证据中呈现出的最明显模式是,吸烟对神经认知恢复主要有负面影响,脑区体积变化与神经认知恢复之间存在关联,且神经认知恢复与自我报告的饮酒量以及教育程度均无关联。需要对研究不足的因素和证据不一致的因素开展进一步研究,最好采用纵向设计,在至少戒酒两周后开始进行多个评估期。