Abstract
Cocaine users consistently display cognitive impairments. However, it is still unknown whether these impairments are cocaine-induced and if they are reversible. Therefore, we examined the relation between changing intensity of cocaine use and the development of cognitive functioning within 1 year. The present data were collected as part of the longitudinal Zurich Cocaine Cognition Study (ZuCo2St). Forty-eight psychostimulant-naive controls and 57 cocaine users (19 with increased, 19 with decreased, and 19 with unchanged cocaine use) were eligible for analysis. At baseline and after a 1-year follow-up, cognitive performance was measured by a global cognitive index and four neuropsychological domains (attention, working memory, declarative memory, and executive functions), calculated from 13 parameters of a broad neuropsychological test battery. Intensity of cocaine use was objectively determined by quantitative 6-month hair toxicology at both test sessions. Substantially increased cocaine use within 1 year (mean +297%) was associated with reduced cognitive performance primarily in working memory. By contrast, decreased cocaine use (−72%) was linked to small cognitive improvements in all four domains. Importantly, users who ceased taking cocaine seemed to recover completely, attaining a cognitive performance level similar to that of the control group. However, recovery of working memory was correlated with age of onset of cocaine use—early-onset users showed hampered recovery. These longitudinal data suggest that cognitive impairment might be partially cocaine-induced but also reversible within 1 year, at least after moderate exposure. The reversibility indicates that neuroplastic adaptations underlie cognitive changes in cocaine users, which are potentially modifiable in psychotherapeutical or pharmacological interventions.
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Acknowledgements
We are grateful to Alex Bücheli (Streetwork Zürich), Rudolf Stohler (Research Group Substance Use Disorders, University Hospital of Psychiatry), Lars Stark and Thilo Beck (ARUD, Zurich), Eric La Serra (Klinik St Pirminsberg, Psychiatrie-Dienste Süd, Kanton St Gallen), Christopher Schütz (Integrated Psychiatry Wintherthur), and Michael Schaub (Swiss Research Institute for Public Health and Addiction, Zürich) for their support of the recruitment of cocaine-using individuals. In addition, we thank Alex Gamma for critical comments to the manuscript and statistical support. Moreover, we thank Daniela Jenni and Kathrin Küpeli for excellent support.
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Vonmoos, M., Hulka, L., Preller, K. et al. Cognitive Impairment in Cocaine Users is Drug-Induced but Partially Reversible: Evidence from a Longitudinal Study. Neuropsychopharmacol 39, 2200–2210 (2014). https://doi.org/10.1038/npp.2014.71
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DOI: https://doi.org/10.1038/npp.2014.71
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