Working memory deficits predict short-term smoking resumption following brief abstinence.
Working memory deficits predict short-term smoking resumption following brief abstinence.
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DOI：
10.1016/j.drugalcdep.2009.07.020
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发表时间：
2010-01-01
影响因子：
4.2
通讯作者：
Lerman C
中科院分区：
文献类型：
--
作者：
Patterson F;Jepson C;Loughead J;Perkins K;Strasser AA;Siegel S;Frey J;Gur R;Lerman C
多达一半的吸烟者在戒烟尝试后的第一周内复发，并且早期戒烟中认知缺陷的主观报告与复发风险增加有关。本研究探讨了在7天的模拟戒烟尝试中，戒烟3天后的客观认知表现是否能预测吸烟的恢复。67名寻求治疗的吸烟者接受伐尼克兰或安慰剂（随机双盲）治疗21天。在药物启动（第1-10天）后，有一个3天的强制性（生物化学证实）禁欲期（第11-13天），在此期间评估工作记忆（Letter-N-Back任务）和持续注意力（持续表现任务）（第13天）。然后，参与者暴露于计划的吸烟间歇期，并被指示在接下来的7天（第15-21天）内尝试保持禁欲。戒烟期间认知表现较差（Letter-N-Back任务的正确反应时间较慢）预示着接受安慰剂的患者恢复吸烟的速度更快（p= 0.038），但接受伐尼克兰的患者则不然。这些数据进一步支持了越来越多的认识，即涉及工作记忆的认知缺陷是尼古丁戒断的核心症状，也是开发药理学和行为治疗的潜在目标。
As many as one-half of smokers relapse in the first week following a quit attempt, and subjective reports of cognitive deficits in early abstinence are associated with increased relapse risk. This study examined whether objective cognitive performance after three days of abstinence predicts smoking resumption in a 7-day simulated quit attempt. Sixty-seven treatment-seeking smokers received either varenicline or placebo (randomized double-blind) for 21 days. Following medication run-up (days 1-10), there was a 3-day mandatory (biochemically confirmed) abstinence period (days 11-13) during which working memory (Letter-N-Back Task) and sustained attention (Continuous Performance Task) were assessed (day 13). Participants were then exposed to a scheduled smoking lapse and instructed to try to remain abstinent for the next 7 days (days 15-21). Poorer cognitive performance (slower correct reaction time on Letter-N-Back task) during abstinence predicted more rapid smoking resumption among those receiving placebo (p=.038) but not among those receiving varenicline. These data lend further support for the growing recognition that cognitive deficits involving working memory are a core symptom of nicotine withdrawal and a potential target for the development of pharmacological and behavioral treatments.
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