Laboratorio de Neuromodulación, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico.
Laboratorio de Neuropsicofarmacología, Dirección de Investigación en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, 101. Col. San Lorenzo Huipulco, CP 14370, Mexico City, Mexico.
Sci Rep. 2024 Jan 16;14(1):1410. doi: 10.1038/s41598-024-51901-2.
Cocaine/crack abstinence periods have higher risk of relapse. Abstinence as initial part of the recovery process is affected by learning and memory changes that could preserve the addictive cycle. To further understand how the interruption of cocaine/crack consumption affects neurotrophin level we performed the present systematic review and meta-analysis following the PRISMA statement (number CRD42019121643). The search formula was conducted in PubMed, Web of Science, Embase, ScienceDirect, and Google Scholar databases. The inclusion criterion was cocaine use disorder in 18 to 60-year-old people, measuring at least one neurotrophin in blood before and after a controlled abstinence period. Studies without pre-post design were excluded. Five investigations had nine different reports, four of them were subjected to a meta-analysis (n = 146). GRADE risk of bias method was followed. Individual studies reported increased peripheral brain derived neurotrophic factor (BDNF) after abstinence, evidence pooled by Hedge's g showed no significant change in BDNF after abstinence. Relevant heterogeneity in the length of the abstinence period (12-32 days), last cocaine/crack consumption monitoring and blood processing were detected that could help to explain non-significant results. Further improved methods are suggested, and a potential BDNF augmentation hypothesis is proposed that, if true, would help to understand initial abstinence as a re-adaptation period influenced by neurotrophins such as the BDNF.
可卡因/快克戒断期有更高的复发风险。戒断作为康复过程的初始阶段，受到学习和记忆变化的影响，这些变化可能会维持成瘾循环。为了进一步了解可卡因/快克消费中断如何影响神经营养因子水平，我们按照 PRISMA 声明（编号 CRD42019121643）进行了本次系统评价和荟萃分析。搜索公式在 PubMed、Web of Science、Embase、ScienceDirect 和 Google Scholar 数据库中进行。纳入标准是 18 至 60 岁的可卡因使用障碍患者，在受控戒断期前后测量至少一种神经营养因子。排除没有预-后设计的研究。五项研究中有九项不同的报告，其中四项进行了荟萃分析（n=146）。采用 GRADE 偏倚风险方法。个体研究报告戒断后外周脑源性神经营养因子（BDNF）增加，Hedge's g 汇总的证据表明戒断后 BDNF 没有显著变化。检测到戒断期（12-32 天）长度、最近可卡因/快克消费监测和血液处理方面的相关异质性，这可能有助于解释非显著结果。建议进一步改进方法，并提出潜在的 BDNF 增强假说，如果这是真的，将有助于理解初始戒断作为受 BDNF 等神经营养因子影响的再适应期。
