Table_1_Effects of Opioid Dependence on Visuospatial Memory and Its Associations With Depression and Anxiety.docx

Introduction: The cognitive impact of opioid dependence is rarely measured systematically in everyday clinical practice even though both patients and clinicians accept that cognitive symptoms often occur in the opioid-dependent population. There are only a few publications which utilized computerized neuropsychological tests to assess possible impairments of visuospatial memory in opioid-dependent individuals either receiving opioid replacement therapy (ORT) or during subsequent short-term abstinence and the effects of anxiety and depression.
Methods: We assessed a cohort of 102 participants, comprising i) a stable opioid-dependent group receiving methadone maintenance treatment (MMT) (n = 22), ii) a stable opioid-dependent group receiving buprenorphine (BMT) (n = 20), iii) a current abstinent but previously opioid-dependent group (ABS) (n = 8), and iv) a control group who have never been dependent on opioids. The Cambridge Neuropsychological Automated Test Battery (CANTAB) neuropsychological tasks undertaken by participants included: Delayed Matching to Sample (DMS), Pattern Recognition Memory (PRM), Spatial Recognition Memory (SRM), and Paired Associate Learning (PAL) tasks. Three clinical measures were used to assess the severity of anxiety and depressive illness: Hospital Anxiety Scale-Hospital Anxiety Depression (HADA)-(HADD), Beck Depression Inventory (BDI), and Inventory of Depressive Symptomatology (self-report) (ISD-SR).
Results: The methadone- and buprenorphine-treated groups showed significant impairments (p < 0.001) in visuospatial memory tasks but not the abstinent group. Impairments in visuospatial memory strongly correlated with higher mood and anxiety symptom severity scores (p < 0.001).
Discussion: These results are broadly consistent with previous studies. Uniquely, though, here we report a strong relationship between visuospatial memory and depression and anxiety scores, which might suggest common illness mechanisms.

引言：尽管患者与临床医师均认可阿片类药物依赖（opioid dependence）人群常出现认知症状，但在日常临床实践中，阿片类药物依赖的认知影响极少被系统性评估。目前仅有少数研究采用计算机化神经心理测试，对接受阿片类替代治疗（opioid replacement therapy, ORT）或处于短期戒断期的阿片类药物依赖者的视空间记忆损伤，以及焦虑、抑郁的影响进行评估。
方法：本研究纳入102名受试者，分为四组：① 接受美沙酮维持治疗（methadone maintenance treatment, MMT）的稳定阿片类药物依赖组（n=22）；② 接受丁丙诺啡（buprenorphine, BMT）治疗的稳定阿片类药物依赖组（n=20）；③ 目前已戒断但既往有阿片类药物依赖史的戒断组（ABS）（n=8）；④ 无阿片类药物依赖史的健康对照组。受试者完成的剑桥自动化神经心理测试组合（Cambridge Neuropsychological Automated Test Battery, CANTAB）任务包括：延迟匹配样本（Delayed Matching to Sample, DMS）、模式再认记忆（Pattern Recognition Memory, PRM）、空间再认记忆（Spatial Recognition Memory, SRM）以及配对联想学习（Paired Associate Learning, PAL）任务。本研究采用3项临床量表评估焦虑与抑郁症状的严重程度：医院焦虑量表-医院焦虑抑郁（HADA-HADD）、贝克抑郁自评量表（Beck Depression Inventory, BDI）以及抑郁症状自评量表（Inventory of Depressive Symptomatology (self-report), ISD-SR）。
结果：美沙酮与丁丙诺啡治疗组在视空间记忆任务中均表现出显著损伤（p<0.001），而戒断组无此表现；视空间记忆损伤程度与情绪及焦虑症状严重程度评分呈显著正相关（p<0.001）。
讨论：本研究结果与既往研究大体一致；但本研究的独特之处在于，我们发现视空间记忆与抑郁、焦虑评分之间存在显著关联，这提示二者可能存在共同的发病机制。