Aprendizaje y memoria verbal: Comparación entre pacientes con trastorno por consumo de alcohol y trastorno de depresión mayor

Rocio Villa Diez, Julia Rodríguez-Revuelta, Ashkan Espandian, Isabel Menéndez-Miranda, Francesco Dal Santo, María Paz García-Portilla, Gerardo Flórez, Julio Bobes, Pilar Alejandra Sáiz Martínez

Resumen


El daño cerebral relacionado con el consumo de alcohol se asocia a alteraciones de las funciones cognitivas, entre las que destacan memoria y aprendizaje verbal. El objetivo principal es evaluar memoria y aprendizaje verbal en una muestra de 111 pacientes con trastorno por consumo de alcohol (TCA) versus 78 con trastorno de depresión mayor (TDM) y 100 controles sanos. La evaluación incluyó variables sociodemográficas y clínicas, la Escala de Hamilton para la Depresión (HDRS) y el Test de Aprendizaje Verbal de California (CVLT). Se utilizó ANOVA de un factor para comparaciones entre los 3 grupos y ANCOVAS bidireccionales incluyendo diferentes covariables. El ANOVA de un factor muestra que los pacientes con TCA y TDM obtienen puntuaciones similares entre sí e inferiores a las del grupo control (p < 0,001), con excepción del CVLT Guiado (peores puntuaciones en TDM vs TCA, p < 0,001). Tras incluir como covariables la edad, sexo y los años de estudios completados, persisten las diferencias entre los grupos de TCA y TDM frente al grupo control (p ≤ 0,003) en todos los índices con excepción del CVLT Libre Inmediato y del CVLT Guiado (peor rendimiento en TDM vs TCA, p = 0,022 y p = 0,035, respectivamente). En el segundo ANCOVA, tras controlar por gravedad de la depresión, únicamente se detectan diferencias entre los pacientes con TCA y los controles sanos (p ≤ 0,007). Los pacientes con TCA presentan una importante alteración en aprendizaje y memoria verbal al compararlos con pacientes con TDM y con personas sanas.

 

Palabras clave


Aprendizaje verbal; California Verbal Learning Test; memoria verbal; trastorno de depresión mayor; trastorno por consumo de alcohol.

Texto completo:

PDF PDF (English)

Referencias


American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5). Arlington, VA: American Psychiatric Publishing.

Bates, M. E., Buckman, J. F. y Nguyen, T. T. (2013). A role for cognitive rehabilitation in increasing the effectiveness of treatment for alcohol use disorders. Neuropsychology Review, 23, 27-47. doi:10.1007/s11065-013-9228-3.

Bech, P. (1996). The Bech, Hamilton and Zung scales for mood disorders: Screening and listening, 2nd ed. Berlin: Springer.

Bell, M. D., Pittman, B., Petrakis, I. y Yoon, G. (2021). Donepezil and cognitive remediation therapy to augment treatment of alcohol use disorder related mild cognitive impairment (AUD-MCI): An open label pilot study with historical controls. Substance abuse 42(4), 412-416. doi:10.1080/08897077.2020.1844847.

Bernardin, F., Maheut-Bosser, A. y Paille, F. (2014). Cognitive impairments in alcohol-dependent subjects. Frontiers in Psychiatry, 16, 78. doi:10.3389/fpsyt.2014.00078.

Bobes, J., Bulbena, A., Luque, A., Dal-Re, R., Ballesteros, J. e Ibarra, N. (2003). Grupo de validación en español de escalas psicométricas. Evaluación psicométrica comparativa de las versiones en español de 6, 7 y 21 ítems de la Escala de valoración de Hamilton para la evaluación de la depresión. Medicina Clínica, 120, 693-700.

Bortolato, B., Miskowiak, K. W., Köler, C. A., Maes, M., Fernandes, B. S., Berk, M. y Carvalho, A. F. (2016). Cognitive remission: A novel objective for the treatment of major depression? BMC Medicine, 14, 9. doi:10.1186/s12916-016-0560-3.

Brust, J. C. M. (2010). Ethanol and cognition: Indirect effects, neurotoxicity and europrotection: A review. International Journal of Environmental Research and Public Health, 7, 1540-1557. doi:10.3390/ijerph7041540.

Crowe, S. F., Cammisuli, D. M. y Stranks, E. K. (2019). Widespread cognitive deficits in alcoholism persistent following prolonged abstinence: An updated meta-analysis of studies that used standardised europsychological assessment tools. Archives of Clinical Neuropsychology, 35, 31-45. doi:10.1093/arclin/acy106.

Delis, D. C., Kramer, J. H., Kaplan, E. y Ober, B. A. (1987). California Verbal Learning Test. Research edition manual. New York: Psychological Corporation.

Erdozain, A. M., Morentin, B., Bedford, L., King, E., Tooth, D., Brewer, C.,... Carter, W. G. (2014). Alcohol-related brain damage in humans. PloS One, 9. doi:10.1371/journal.pone.0093586.

Florez, G., Espandian, A., Villa, R. y Saiz, P. A. (2019). Clinical implications of cognitive impairment and alcohol dependence. Adicciones, 31, 3-7. doi:10.20882/adicciones.1284.

Fossatti, P., Deweer, B., Raoux, N. y Allilaire, J. F. (1995). Deficits in memory retrieval: An argument in favor of frontal subcortical dysfunction in depression. L’Encephale, 21, 295-305.

Fossatti, P., Coyette, F., Ergis, A. M. y Allilaire, J. F. (2002). Influence of age and executive functioning on verbal memory of inpatients with depression. Journal of Affective Disorders, 68, 261-271. doi:10.1016/s0165-0327(00)00362-1.

Frias-Torres, C., Moreno-Espana, J., Ortega, L., Barrio, P., Gual, A. y Teixidor Lopez, L. (2018). Remediation therapy in patients with alcohol use disorders and neurocognitive disorders: A pilot study. Adicciones, 30, 93-100. doi:10.20882/adicciones.757.

Gregory, E., Torres, I. J., Ge, R., Blumberger, D. M., Downar, J. H., Daskalakis, Z. J.,… Vila-Rodriguez, F. (2020). Predictors of cognitive impairment in treatment-resistant depression. Journal of Affective Disorders, 274, 593-601. doi:10.1016/j.jad.2020.05.10.

Hamilton, M. (1960). A rating scale for depression. Journal of Neurology Neurosurgery and Psychiatry, 23, 56-62. doi:10.1136/jnnp.23.1.56.

Hayes, V., Demirkol, A., Ridley, N., Withall, A. y Draper, B. (2016). Alcohol-related cognitive impairment: Current trends and future perspectives. Neurodegenerative Disease Management, 6, 509-523. doi:10.2217/nmt-2016-0030.

Hunt, S. A., Baker, A. L., Michie, P. T. y Kavanagh, D. J. (2009). Neurocognitive profiles of people with comorbid depression and alcohol use: Implications for psychological interventions. Addictive behaviors, 34, 878-886. doi:10.1016/j.addbeh.2009.03.036.

Hunt, S. A., Kay-Lambkin, F. J., Baker, A. L. y Michie, P. T. (2015). Systematic review of neurocognition in people with co-occurring alcohol misuse and depression. Journal of affective disorders, 179, 51-64. doi:10.1016/j.jad.2015.03.024.

Kopera, M., Wojnar, M., Brower, K., Glass, J., Nowosad, I., Gmaj, B. y Szelenberger, W. (2012). Cognitive functions in abstinent alcohol-dependent patients. Alcohol, 46, 666-671. doi:10.1016/j.alcohol.2012.04.005.

Kramer, A. O., Casaletto, K. B., Umlauf, A., Staffaroni, A. M., Fox, E., You, M. y Kramer, J. H. (2019). Robust normative standards for the California Verbal Learning Test (CVLT) ages 60–89: A tool for early detection of memory impairment. Clinical Neuropsychologist, 34, 384-405.doi:10.1080/13854046.2019.1619838.

Ku´zma, E., Llewellyn, D. J., Langa, K. M., Wallace, R. B. y Lang, I. A. (2014). History of alcohol use disorders and risk of severe cognitive impairment: A 19-year prospective cohort study. American Journal of the Geriatric Psychiatry, 22, 1047-1054.  doi:10.1016/j.jagp.2014.06.001.

Le Berre, A. P., Fama, R. y Sullivan, E. V. (2017). Executive functions, memory, and social cognitive deficits and recovery in chronic alcoholism: A critical review to inform future research. Alcoholism, Clinical and Experimental Research, 41, 1432-1443. doi:10.1111/acer.13431.

Lee, R. S., Dore, G., Juckes, L., De Regt, T., Naismith, S. L., Lagopoulos, J.,… Hermens, D. F. (2015). Cognitive dysfunction and functional disability in alcohol-dependent adults with or without a comorbid affective disorder. Cognitive neuropsychiatry20, 222-231. doi:10.1080/13546805.2015.1014031.

Lee, R. S., Hermens, D. F., Porter, M. A. y Redoblado-Hodge, M. A. (2012). A meta-analysis of cognitive deficits in first-episode major depressive disorder. Journal of Affective Disorders140, 113-124. doi:10.1016/j.jad.2011.10.023.

Lundervold, A. J., Wollschläger, D. y Wehling, E. (2014). Age and sex related changes in episodic memory function in middle aged and older adults. Scandinavian Journal of Psychology, 55, 225-232. doi:10.1111/sjop.12114.

Maharasingam, M., Macniven, J. A. y Mason, O. J. (2013). Executive functioning in chronic alcoholism and Korsakoff syndrome. Journal of Clinical and Experimental Neuropsychology, 35, 501-508. doi:10.1080/13803395.2013.795527.

Marazziti, D., Consoli, G., Picchetti, M., Carlini, M. y Faravelli, L. (2010). Cognitive impairment in major depression. European Journal of Pharmacology, 626, 83-86. doi:10.1016/j.ejphar.2009.08.046.

McDermott, L. M. y Ebmeier, K. P. (2009). A meta-analysis of depression severity and cognitive function. Journal of Affective Disorders, 119, 1-8. doi:10.1016/j.jad.2009.04.022.

Mesholam-Gately, R. I., Giuliano, A. J., Zillmer, E. A., Barakat, L. P., Kumar, A., Gur, R. C.,… Moberg, P. J. (2012). Verbal learning and memory in older adults with minor and major depression. Archives of Clinical Neuropsychology, 27, 196-207.doi:10.1093/arclin/acr106.

Millan, M. J., Agid, Y., Brüne, M., Bullmore, E. T., Carter, C. S., Clayton, N. S.,… Young, L. J. (2012). Cognitive dysfunction in psychiatric disorders: Characteristics, causes and the quest for improved therapy. Nature Reviews Drug Discovery, 11, 141-168. doi:10.1038/nrd3628.

Moreira, P. S., Santos, N. C., Sousa, N. y Costa, P. S. (2015). The use of canonical correlation analysis to assess the relationship between executive functioning and verbal memory in older adults. Gerontology and Geriatric Medicine, 1. doi:10.1177/2333721415602820.

Moretti, R., Caruso, P., Dal Ben, M., Gazzin, S. y Tiribelli, C. (2017). Thiamine and alcohol for brain pathology: Super-imposing or different causative factors for brain damage? Current Drug Abuse Reviews, 10, 44-51. doi:10.2174/1874473711666180402142012.

Noël, X., Van der Linden, M., Schmidt, N., Sferrazza, R., Hanak, C., Le Bon, O.,… Verbanck, P. (2001). Supervisory attentional system in nonamnesic alcoholic men. Archives of General Psychiatry, 58, 1152. doi:10.1001/archpsyc.58.12.1152.

Nuño, L., Gómez-Benito, J., Carmona, V. R. y Pino, O. (2021). A systematic review of executive function and information processing speed in major depression disorder. Brain Sciences, 11, 147. doi:10.3390/brainsci11020147.

Oscar-Berman, M., Valmas, M. M., Sawyer, K. S., Ruiz, S. M., Luhar, R. B. y Gravitz, Z. R. (2014). Profiles of impaired, spared, and recovered neuropsychological processes in alcoholism. Handbook of Clinical Neurology, 125, 183-210. doi:10.1016/B978-0-444-62619-6.00012-4.

Pitel, A. L., Beaunieux, H., Witkowski, T., Vabret, F., Guillery-Girard, B., Quinette, P.,… Eustache, F. (2007). Genuine episodic memory deficits and executive dysfunctions in alcoholic subjects early in abstinence. Alcoholism, Clinical and Experimental Research, 31, 1169-1178. doi:10.1111/j.1530-0277.2007.00418.x.

Ridley, N. J., Draper, B. y Withall, A. (2013). Alcohol-related dementia: An update of the evidence. Alzheimer’s Research and Therapy, 5, 3. doi:10.1186/alzrt157.

Rock, P. L., Roiser, J. P., Riedel, W. J. y Blackwell, A. D. (2014). Cognitive impairment in depression: A systematic review and meta-analysis. Psychological Medicine, 44, 2029-2040. doi:10.1017/S0033291713002535.

Roca, M., Vives, M., López-Navarro, E., García-Campayo, J. y Gili, M. (2015). Cognitive impairments and depression: A critical review. Actas Españolas de Psiquiatría, 43, 187-193.

Ros-Cucurull, E., Palma-Alvarez, R. F., Cardona-Rubira, C., Garcia-Raboso, E., Jacas, C., Grau-Lopez, L.,… Roncero, C. (2018). Alcohol use disorder and cognitive impairment in old age patients: A 6 months follow-up study in an outpatient unit in Barcelona. Psychiatry Research, 261, 361-366. doi:10.1016/j.psychres.2017.12.069.

Rupp, C. I., Kemmler, G., Kurz, M., Hinterhuber, H. y Fleischhacker, W. W. (2012). Cognitive remediation therapy during treatment for alcohol dependence. Journal of studies on alcohol and drugs73, 625-634. doi:10.15288/jsad.2012.73.625.

Sachdeva, A., Chandra, M., Choudhary, M., Dayal, P. y Anand, K. S. (2016). Alcohol-related dementia and neurocognitive impairment: A review study. International Journal of High Risk Behaviors and Addiction, 5. doi:10.5812/ijhrba.27976.

Spear, L. P. (2018). Effects of adolescent alcohol consumption on the brain and behaviour. Nature Reviews Neuroscience, 19, 197-214. doi:10.1038/nrn.2018.10.

Stavro, K., Pelletier, J. y Potvin, S. (2013). Widespread and sustained cognitive deficits in alcoholism: A meta-analysis. Addiction Biology, 18, 203-213. doi:10.1111/j.1369-1600.2011.00418.x.

Sullivan, E. V., Rosenbloom, M. J., Lim, K. O. y Pfefferbaum, A. (2000). Longitudinal changes in cognition, gait, and balance in abstinent and relapsed alcoholic men: Relationships to changes in brain structure. Neuropsychology, 14, 178-188.

Svanberg, J. y Evans, J. J. (2013). Neuropsychological rehabilitation in alcohol-related brain damage: A systematic review. Alcohol and Alcoholism, 48, 704-711. doi:10.1093/alcalc/agt131.

Toledo-Nunes, P., Kipp, T. K., Reitz, N. L. y Savage, L. M. (2019). Aging with alcohol-related brain damage: Critical brain circuits associated with cognitive dysfunction. International Review of Neurobiology, 148, 101-168. doi:10.1016/bs.irn.2019.09.002.

Topiwala, A., Allan, C. L., Valkanova, V., Zsoldos, E., Filippini, N., Sexton, C.,… Ebmeier, K. P. (2017). Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: Longitudinal cohort study. BMJ, 357. doi:10.1136/bmj.j2353.

Van Geldorp, B., Bergman, H. C., Robertson, J., Wester, A. J. y Kessels, R. P. C. (2012). The interaction of working memory performance and episodic memory formation in patients with Korsakoff’s amnesia. Brain Research, 1433, 98-103. doi:10.1016/j.brainres.2011.11.036. 

Villa, R., Espandian, A., Saiz, P. A., Astals, M., Valencia, J. K., Martinez-Santamaria, E.,... Florez G. (2021). Cognitive functioning in patients with alcohol use disorder who start outpatient treatment. Adicciones, 33, 161-174.doi:10.20882/adicciones.1326.

Villa, R., Espandian, A., Saiz, Rodriguez-Revuelta, J., Garcia-Portilla, P., Bobes, J. y Florez, G. (2022). Cognitive functioning after six months of follow-up in a sample of alcohol use disorder outpatients.Adicciones, 34(4), 309-322.doi:10.20882/adicciones.1672.

Wester, A. J., Roelofs, R. L., Egger, J. I. M. y Kessels, R. P. C. (2014). Assessment of alcohol-related memory deficits: A comparison between the Rivermead Behavioural Memory Test and the California Verbal Learning Test. Brain Impairment, 15, 18-27. doi:10.1017/BrImp.2014.6.

Wollenweber, F. A., Halfter, S., Brugmann, E., Weinberg, C., Cieslik, E. C., Muller, V. I.,... Eickhoff, S. B. (2014). Subtle cognitive deficits in severe alcohol addicts—do they show a specific profile? Journal of Neuropsychology, 8, 147-153. doi:10.1111/jnp.12001.

World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310, 2191-2194. doi:10.1001/jama.2013.281053.

Zahr, N. M. y Pfefferbaum, A. (2017). Alcohol’s effects on the brain: Neuroimaging results in humans and animal models. Alcohol Research: Current Reviews, 38, 183-206.




DOI: https://doi.org/10.20882/adicciones.1696

Enlaces refback

  • No hay ningún enlace refback.