La respuesta de sobresalto y la inhibición prepulso en los trastornos por uso de alcohol. Implicaciones para la práctica clínica

Abstract

In recent years, the addictive processes and more specifically Alcohol Use Disorders (AUD) have been studied using different neuropsychological and neurophysiological approaches, including the Startle Response (SR) and the Prepulse Inhibition (PPI). In this article we present the results of three studies carried out by our group. The first study included 19 male patients who had alcohol dependence and were detoxified for a period of 10-14 days, undergoing testing for SR and PPI at baseline and after the detoxification treatment. The second study included 60 abstinent alcoholic men who had been abstinent for more than a month and who were compared with healthy controls. The sample of the third studied included 40 alcohol dependent men, who proceeded from study 2, and who were assessed with laboratory impulsivity paradigms after having been tested on SR and PPI. Our studies have found that alcohol dependent patients exhibit a reduced magnitude of the SR and impairments in the PPI compared to healthy controls. Impairments in the PPI are even more evident when the subject is actively consuming alcohol and during early detoxification, and tend to partially improve after the detoxification process is successfully completed, although percentages of PPI do not reach the levels of healthy controls. Finally, we found that variables of the SR and variables of impulsivity were correlated in abstinent alcohol dependent patients, but not in controls. In conclusion, SR and PPI could be useful tools for the assessment of patients with alcohol dependence. They could either be considered as vulnerability markers for the development of alcohol or be an index of alcohol neurotoxicity in the central nervous system.