Opioid-associated amnestic syndrome: Description of the syndrome and validation of a proposed definition
Opioid-associated amnestic syndrome: Description of the syndrome and validation of a proposed definition
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DOI：
10.1016/j.jns.2020.117048
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发表时间：
2020-10-15
影响因子：
4.4
通讯作者：
Ganetsky, Michael
中科院分区：
文献类型：
--
作者：
Barash, Jed A.;Whitledge, James;Ganetsky, Michael
目的：报道了一种阿片类药物相关遗忘综合征（OAS），其特征是急性发作的记忆丧失和双侧海马信号异常，在阿片类药物使用史的背景下，最明显的是芬太尼。然而，到目前为止，还没有病例定义来帮助神经科医生和其他临床医生识别这种综合征。包括神经科医生在内的多学科医师合作，利用已在医学文献中发表或在会议上提出的病例，提出OAS的诊断标准。方法：根据脑成像结果和支持阿片类药物使用的病史或分析测试，将病例分为确诊、可能或可能。通过与公共卫生当局的讨论和对PubMed的系统搜索，确定了已发表的文章和报告。包括截至2019年11月的文章、摘要或海报，这些文章、摘要或海报介绍了与双侧海马损伤相关的新发遗忘综合征的病例报告或病例系列，涉及影像学和/或先前使用阿片类药物或其他物质。计算符合确诊、可能或可能标准的病例百分比。结果：所有来源的23篇出版物符合纳入标准，占40例独特病例。根据OAS病例定义，50%（20/40）为确诊病例，25%（10/40）为可能病例，25%（10/40）为可能病例。结论：开发一个有效的、正式的OAS病例定义可以帮助神经科医生和其他临床医生评估失忆症和阿片类药物使用史的患者。
Objective: An opioid-associated amnestic syndrome (OAS) characterized by acute onset memory loss and bilateral hippocampal signal abnormalities on brain imaging in the setting of a history of opioid use, most notably fentanyl, has been reported. To date, however, there is no case definition to assist neurologists and other clinicians in identifying this syndrome. A multi-disciplinary collaboration of physicians, including neurologists, propose diagnostic criteria for OAS using cases that have been published in the medical literature or presented at conferences.Methods: Cases were classified as confirmed, probable, or possible based on brain imaging findings and history or analytical testing supporting opioid use. Published articles and presentations were identified by discussion with public health authorities and a systematic search of PubMed. Included were articles, abstracts or posters through November 2019 that presented case reports or case series of a new-onset amnestic syndrome associated with bilateral hippocampal injury on imaging and/or prior opioid or other substance use. The percentages of cases that would meet confirmed, probable, or possible criteria were calculated.Results: Twenty-three publications from all sources met criteria for inclusion, accounting for 40 unique cases. Based on the case definition of OAS, 50% (20/40) were confirmed, 25% (10/40) were probable and 25% (10/40) were possible.Conclusion: The development of a validated, formal case definition for OAS can assist neurologists and other clinicians in evaluating patients with amnesia and a history of opioid use.