Background: The recreational use of gamma hydroxybutyrate (GHB) is associated with frequent overdoses, coma and the risk of developing GHB use disorder (GUD). Several studies suggest negative effects of GHB use or related comas on cognition. Since relapse rates are high in GUD and cognitive impairment has been associated with relapse in other substance use disorders, we aimed to (1) investigate the prevalence of cognitive impairment before and after detoxification, (2) analyse the relationship between GHB use, comas, and cognitive impairment, and (3) explore the association between cognitive impairment and relapse after detoxification in GUD patients. Methods: In these secondary analyses of a prospective cohort study, a consecutive series of patients with GUD (n = 103) admitted for detoxification were recruited at six addiction care facilities in the Netherlands. The Montreal Cognitive Assessment (MoCA) was used to screen for cognitive impairments before and after detoxification. The follow-up duration for the assessment of relapse in GHB use was 3 months. Results: A substantial number of patients with GUD screened positive for cognitive impairment before (56.3%) and after (30.6%) detoxification. Impairment on the MoCA memory domain was most frequent (58.8%). Cognitive impairment was not related to the severity of GUD or number of GHB-induced comas. Logistic regression analysis showed that only the memory score independently predicted relapse. Discussion: Cognitive impairment seems highly prevalent among patients with GUD, possibly related to the risk of relapse. The absence of a relationship between the severity of GUD, level of GHB use, the number of GHB-induced comas, and cognitive impairment suggest that other factors may also contribute to the observed cognitive impairment.
Eur Addict Res

中文翻译：

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GHB 使用障碍患者的认知障碍预测 GHB 使用的复发

背景： γ-羟基丁酸 (GHB) 的娱乐性使用与频繁过量服用、昏迷和发生 GHB 使用障碍 (GUD) 的风险有关。几项研究表明 GHB 使用或相关昏迷对认知的负面影响。由于 GUD 的复发率很高，并且认知障碍与其他物质使用障碍的复发有关，我们旨在 (1) 调查解毒前后认知障碍的患病率，(2) 分析 GHB 使用、昏迷、和认知障碍，(3) 探讨 GUD 患者认知障碍与解毒后复发之间的关系。方法：在这些前瞻性队列研究的二次分析中，连续系列的 GUD 患者（ n= 103) 在荷兰的六个戒毒护理机构招募了因戒毒而入院的人员。蒙特利尔认知评估 (MoCA) 用于筛查戒毒前后的认知障碍。评估 GHB 使用复发的随访时间为 3 个月。结果：大量 GUD 患者在 (56.3%) 和 (30.6%) 解毒之前筛查出认知障碍阳性。MoCA 记忆域受损最为常见（58.8%）。认知障碍与 GUD 的严重程度或 GHB 诱导的昏迷次数无关。逻辑回归分析表明，只有记忆评分独立预测复发。讨论：认知障碍似乎在 GUD 患者中非常普遍，可能与复发风险有关。GUD 的严重程度、GHB 使用水平、GHB 诱导的昏迷次数和认知障碍之间没有关系，这表明其他因素也可能导致观察到的认知障碍。
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