Alcohol-Related Impairment and Reinforcement after Gastric Bypass Surgery

摘要： 最近，我们的研究小组在JAMA上发表了一篇论文，表明Roux-en-Y胃肠道后， 在心脏搭桥手术（RYGB）中，患者发生酒精使用障碍的风险显著增加。 几条研究线与这一发现一致：1）RYGB患者的轶事信息 表明他们更快地喝醉，2）有许多关于汽车的报道 RYGB患者在喝了少量酒后酒后驾车导致的事故 酒精; 3）RYGB后酒精的药代动力学发生显著变化。药代动力学 我们对这些变化非常感兴趣，因为它们可能导致重大损害和变化， 加固.这些变化可能作为一个潜在的因果机制，为随后的 酒精使用障碍的发展。在目前的研究中，我们建议调查RYGB患者 具有前瞻性的纵向设计。我们将检查手术后的认知和驾驶障碍， 并研究RYGB患者可能发生的强化变化。最后，我们的目标是更好地 描述减肥手术后酒精药代动力学的变化， 检查可能在酒精使用障碍的发展中发挥作用的关键变量。

Abstract: Recently our research group published a paper in JAMA which showed that after Roux-en-Y gastric bypass surgery (RYGB), patients are at significantly increased risk for developing an alcohol use disorder. Several lines of research are consistent with this finding: 1) anecdotal information from RYGB patients suggests that they become intoxicated much more quickly, 2) there are numerous reports of automobile accidents that have resulted from RYGB patients driving while intoxicated after drinking a small amount of alcohol, and 3) the pharmacokinetics of alcohol change considerably after RYGB. The pharmacokinetic changes are of considerable interest to us as they likely lead to significant impairments and changes in reinforcement. These changes may serve as a potential causal mechanism for the subsequent development of an alcohol use disorder. In the current study we propose to investigate RYGB patients with a prospective, longitudinal design. We will examine cognitive and driving impairment after surgery as well as study the changes in reinforcement that may occur in RYGB patients. Finally, we aim to better characterize the changes that occur in the pharmacokinetics of alcohol following bariatric surgery and examine key variables which may play a role in the development in alcohol use disorders.