Abstract
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.
Highlights
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
The maintenance treatment (MMT), BMT, and abstinent but previously opioiddependent group (ABS) groups were older than the healthy controls (HCs) (p < 0.001)
Values are mean (SD); significance *** = P < 0.001; DMS, Delayed Matching to Sample; PRM, Pattern Recognition Memory, SRM, Spatial Recognition Memory; PAL, Paired Associate Learning; SWM, Spatial Working Memory; N, total number. In this clinically well-characterized study, we have demonstrated that memory for visually presented patterns and spatial locations was impaired in individuals on opioid replacement therapy (ORT)
Summary
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. Individuals with a history of longterm opioid dependence may demonstrate cognitive impairments, primarily within the executive functioning domains [2,3,4,5,6,7,8]. These impairments have been linked to grey matter reductions in the prefrontal cortex, anterior mid-cingulate cortex, and basal ganglia [9], brain regions thought responsible for the regulation of cravings, pain, and emotional experience. Specific memory tasks have shown to be sensitive and useful in detecting brain dysfunction in the temporal and amygdalohippocampal regions [14], which are consistently reported as functionally abnormal in mood disorders and sensation-seeking behaviors [15,16,17]
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