Bruna Mayara Lopes1, Priscila Dib Gonçalves2, Mariella Ometto3, Bernardo Dos Santos4, Mikael Cavallet5, Tiffany Moukbel Chaim-Avancini5, Mauricio Henriques Serpa5, Sergio Nicastri6, André Malbergier7, Geraldo F Busatto5, Arthur Guerra de Andrade7, Paulo Jannuzzi Cunha8. 1. Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, Faculty of Medicine, University of São Paulo (USP), Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil. Electronic address: pjcunha@usp.br. 2. Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, Faculty of Medicine, University of São Paulo (USP), Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil; Interdisciplinary Group of Studies on Alcohol and Drugs (GREA), Faculty of Medicine, USP, Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil; Psychology & Neuropsychology Service, IPq, USP, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil. 3. Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, Faculty of Medicine, University of São Paulo (USP), Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil; Equilibrium Program, Department of Psychiatry, Faculty of Medicine, USP, Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil. 4. School of Nursing, University of São Paulo, Rua Dr. Enéias de Carvalho Aguiar, 419, Cerqueira César, 05403-000 São Paulo, SP, Brazil. 5. Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, Faculty of Medicine, University of São Paulo (USP), Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil. 6. Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, Faculty of Medicine, University of São Paulo (USP), Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil; Interdisciplinary Group of Studies on Alcohol and Drugs (GREA), Faculty of Medicine, USP, Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil. 7. Interdisciplinary Group of Studies on Alcohol and Drugs (GREA), Faculty of Medicine, USP, Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil. 8. Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, Faculty of Medicine, University of São Paulo (USP), Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil; Interdisciplinary Group of Studies on Alcohol and Drugs (GREA), Faculty of Medicine, USP, Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil; Equilibrium Program, Department of Psychiatry, Faculty of Medicine, USP, Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil.
Abstract
INTRODUCTION: Adolescence is a crucial period for neurodevelopment, but few studies have investigated the impact of early cocaine use on cognitive performance and patterns of substance use. METHODS: We evaluated 103 cocaine dependent inpatients divided in two groups: early-onset users (EOG; n=52), late-onset users (LOG; n=51), and 63 healthy controls. Neuropsychological functioning was evaluated using Digits Forward (DF) and Backward (DB), Trail Making Test (TMT), Stroop Color Word Test (SCWT), Controlled Oral Word Association Test (COWAT), Wisconsin Card Sorting Test (WCST), Rey Osterrieth Complex Figure Test (ROCFT), Frontal Assessment Battery (FAB), and Iowa Gambling Test (IGT). Use of alcohol and other drugs was assessed with the Addiction Severity Index (ASI-6). RESULTS: Analyses of covariance controlling for age, IQ and years of education showed that EOG presented worse performance in attention span (DF, p=0.020), working memory (DB, p=0.001), sustained attention (WCST, p=0.030), declarative memory (ROCFT, p=0.031) and general executive functioning (FAB, p=0.003) when compared with the control group. LOG presented impairments on divided attention (TMT, p=0.003) and general executive functioning (FAB, p=0.001) in relation to the control group. EOG presented higher use of cannabis and alcohol than LOG (p≤0.001). CONCLUSION: Early-onset cocaine users display more pronounced neuropsychological alterations than controls, as well as a greater frequency of polydrug consumption than LOG. The prominent cognitive deficits in EOG probably reflect the deleterious interference of cocaine use with early stages of neurodevelopment. This may be related to more severe clinical characteristics of substance disorder in this subgroup, including polysubstance abuse.
INTRODUCTION: Adolescence is a crucial period for neurodevelopment, but few studies have investigated the impact of early cocaine use on cognitive performance and patterns of substance use. METHODS: We evaluated 103 cocaine dependent inpatients divided in two groups: early-onset users (EOG; n=52), late-onset users (LOG; n=51), and 63 healthy controls. Neuropsychological functioning was evaluated using Digits Forward (DF) and Backward (DB), Trail Making Test (TMT), Stroop Color Word Test (SCWT), Controlled Oral Word Association Test (COWAT), Wisconsin Card Sorting Test (WCST), Rey Osterrieth Complex Figure Test (ROCFT), Frontal Assessment Battery (FAB), and Iowa Gambling Test (IGT). Use of alcohol and other drugs was assessed with the Addiction Severity Index (ASI-6). RESULTS: Analyses of covariance controlling for age, IQ and years of education showed that EOG presented worse performance in attention span (DF, p=0.020), working memory (DB, p=0.001), sustained attention (WCST, p=0.030), declarative memory (ROCFT, p=0.031) and general executive functioning (FAB, p=0.003) when compared with the control group. LOG presented impairments on divided attention (TMT, p=0.003) and general executive functioning (FAB, p=0.001) in relation to the control group. EOG presented higher use of cannabis and alcohol than LOG (p≤0.001). CONCLUSION: Early-onset cocaine users display more pronounced neuropsychological alterations than controls, as well as a greater frequency of polydrug consumption than LOG. The prominent cognitive deficits in EOG probably reflect the deleterious interference of cocaine use with early stages of neurodevelopment. This may be related to more severe clinical characteristics of substance disorder in this subgroup, including polysubstance abuse.
Authors: Kathryn C Fitzgerald; Pauline M Maki; Yanxun Xu; Wei Jin; Raha Dastgheyb; Dionna W Williams; Gayle Springer; Kathryn Anastos; Deborah Gustafson; Amanda B Spence; Adaora A Adimora; Drenna Waldrop; David E Vance; Hector Bolivar; Victor G Valcour; Leah H Rubin Journal: Front Psychol Date: 2020-10-15