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FrancoAngeli Journals

Saggi, Studi e Ricerche

N. 61 (2023)

La Batteria per le Funzioni Esecutive nell’Addiction - BFE-A: un nuovo tool digitalizzato per lo screening neurocognitivo

DOI
https://doi.org/10.3280/mis61-2022oa16472
Inviata
11 settembre 2023
Pubblicato
29-09-2023

Abstract

According to recent neurocognitive models of addictions, a vicious combination of altered executive functions (EF) and dysfunctional reward system represents a main determinant of clinical picture. Executive dysfunctions also have a great impact on worsening addiction disorders as well as on treatment outcomes. Thus, detecting executive dysfunctions with sensitive tools is crucial in order to tailor therapeutic and rehabilitative interventions to patients. We here report the testing of the Battery for Executive Functions in Addiction (BFE-A), a novel battery for EF screening.151 patients with Substance-Use Disorder and 56 health participants completed the seven digitized BFE-A subtests tapping on: learning and memory, working memory, cognitive flexibility, focused attention, attention regulation, and inhibitory control. First-level statistical analyses highlighted lower performance of the clinical sample with respect to healthy participants across all the battery subtests, though verbal memory and focused attention proved to be te most impaired functions. Regression analyses, then, revealed that longer abstinence led to greater memory performance and that a longer history of substance abuse specifically led to less efficient information-processing speed. Findings provide support to the evaluation of the BFE-A as a brief but informative screening battery, potentially complementing the diagnostic process in clinical settings.

Riferimenti bibliografici

  1. Aharonovich E., Brooks A.C., Nunes E.V., Hasin D.S. (2008). Cognitive deficits in marijuana users: effects on motivational enhancement therapy plus cognitive behavioral therapy treatment outcome. Drug and Alcohol Dependence, 95(3): 279-283. DOI: 10.1016/j.drugalcdep.2008.01.009.
  2. Aharonovich E., Hasin D.S., Nunes E.V., Stohl M., Cannizzaro D., Sarvet A., … Genece K.G. (2018). Modified cognitive behavioral therapy (M-CBT) for cocaine dependence: development of treatment for cognitively impaired users and results from a Stage 1 trial. Psychology of Addictive Behaviors, 32(7): 800-811. DOI: 10.1037/adb0000398.
  3. Antons S., Brand M., Potenza M.N. (2020). Neurobiology of cue-reactivity, craving, and inhibitory control in non-substance addictive behaviors. Journal of the Neurological Sciences, 415(May), 116952. DOI: 10.1016/j.jns.2020.116952.
  4. Baidoo N., Wolter M., Leri F. (2020). Opioid withdrawal and memory consolidation. Neuroscience and Biobehavioral Reviews, 114: 16-24. DOI: 10.1016/j.neubiorev.2020.03.029.
  5. Balconi M., Campanella S., Finocchiaro R. (2017). Web addiction in the brain: cortical oscillations, autonomic activity, and behavioral measures. Journal of Behavioral Addictions, 6(3): 334–344. DOI: 10.1556/2006.6.2017.041.
  6. Balconi M., Crivelli D. (2021). The assessment of executive functions: a new neuropsychological tool for addiction. In Balconi M., Campanella S. (Eds.), Advances in Substance and Behavioral Addiction. The Role of Executive Functions (pp. 61-85). Cham: Springer. DOI: 10.1007/978-3-030-82408-2_3.
  7. Balconi M., Finocchiaro R. (2016). Deficit in rewarding mechanisms and prefrontal left/right cortical effect in vulnerability for internet addiction. Acta Neuropsychiatrica, 28(5): 272-285. DOI: 10.1017/neu.2016.9.
  8. Balconi M., Losasso D., Balena A., Crivelli D. (2022a). BFE-A - Batteria per le Funzioni Esecutive nell’Addiction [Battery for Exective Functions in Addiction]. Firenze: Giunti Psychometrics.
  9. Balconi M., Losasso D., Balena A., Crivelli D. (2022b). Neurocognitive impairment in addiction: a digital tool for executive function assessment. Frontiers in Psychiatry, 13, 955277. DOI: 10.3389/fpsyt.2022.955277.
  10. Battisti R.A., Roodenrys S., Johnstone S.J., Pesa N., Hermens D.F., Solowij N. (2010). Chronic cannabis users show altered neurophysiological functioning on Stroop task conflict resolution. Psychopharmacology, 212(4): 613-624. DOI: 10.1007/s00213-010-1988-3.
  11. Bechara A. (2005). Decision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective. Nature Neuroscience, 8(11): 1458-1463. DOI: 10.1038/nn1584.
  12. Blume A.W., Marlatt G.A. (2009). The role of executive cognitive functions in changing substance use: what we know and what we need to know. Annals of Behavioral Medicine, 37(2): 117-125. DOI: 10.1007/s12160-009-9093-8.
  13. Blume A.W., Schmaling K.B., Marlatt G.A. (2005). Memory, executive cognitive function, and readiness to change drinking behavior. Addictive Behaviors, 30(2): 301-314. DOI: 10.1016/j.addbeh.2004.05.019.
  14. Brand M., Wegmann E., Stark R., Müller A., Wölfling K., Robbins T.W., Potenza M.N. (2019). The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors. Neuroscience and Biobehavioral Reviews, 104: 1-10. DOI: 10.1016/j.neubiorev.2019.06.032.
  15. Brorson H.H., Ajo Arnevik E., Rand-Hendriksen K., Duckert F. (2013). Drop-out from addiction treatment: a systematic review of risk factors. Clinical Psychology Review, 33(8): 1010-1024. DOI: 10.1016/j.cpr.2013.07.007.
  16. Buckholtz J.W., Meyer-Lindenberg A. (2012). Psychopathology and the human connectome: toward a transdiagnostic model of risk for mental illness. Neuron, 74(6): 990-1004. DOI: 10.1016/j.neuron.2012.06.002.
  17. Carroll K.M., Kiluk B.D., Nich C., Babuscio T.A., Brewer J.A., Potenza M.N., … Lejuez C.W. (2011). Cognitive function and treatment response in a randomized clinical trial of computer-based training in Cognitive-Behavioral Therapy. Substance Use and Misuse, 46(1): 23–34. DOI: 10.3109/10826084.2011.521069.
  18. Cohen J. (1988). Statistical power analysis for the behavioral sciences (II). Hillsdale, NJ: Lawrence Erlbaum Associates.
  19. Copersino M.L., Schretlen D.J., Fitzmaurice G.M., Lukas S.E., Faberman J., Sokoloff J., Weiss R.D. (2012). Effects of cognitive impairment on substance abuse treatment attendance: predictive validation of a brief cognitive screening measure. The American Journal of Drug and Alcohol Abuse, 38(3): 246-250. DOI: 10.3109/00952990.2012.670866.
  20. Crivelli D., Balconi M. (2021). Psychopathology of EFs. In Balconi M., Campanella S. (Eds.), Advances in Substance and Behavioral Addiction. The Role of Executive Functions (pp. 41-59). Cham: Springer. DOI: 10.1007/978-3-030-82408-2_2.
  21. Crivelli D., Balena A., Losasso D., Balconi M. (2022). Screening executive functions in Substance-Use Disorder: first evidence from testing of the Battery for Executive Functions in Addiction (BFE-A). International Journal of Mental Health and Addiction, Advance Online Publication. DOI: 10.1007/s11469-022-00928-5.
  22. Dean A.C., Kohno M., Morales A.M., Ghahremani D.G., London E.D. (2015). Denial in methamphetamine users: associations with cognition and functional connectivity in brain. Drug and Alcohol Dependence, 151: 84-91. DOI: 10.1016/j.drugalcdep.2015.03.004.
  23. Dipartimento per le Politiche Antidroga (2022). Relazione annuale al Parlamento sul fenomeno delle dipendenze in Italia Presidenza del Consiglio dei Ministri. Anno 2022.
  24. Domínguez-Salas S., Díaz-Batanero C., Lozano-Rojas O.M., Verdejo-García A. (2016). Impact of general cognition and executive function deficits on addiction treatment outcomes: systematic review and discussion of neurocognitive pathways. Neuroscience and Biobehavioral Reviews, 71: 772-801. DOI: 10.1016/j.neubiorev.2016.09.030.
  25. Dubois B., Slachevsky A., Litvan I., Pillon B. (2000). The FAB: a frontal assessment battery at bedside. Neurology, 55(11): 1621-1626. DOI: 10.1212/WNL.55.11.1621.
  26. EMCDDA (2022). Statistical Bulletin 2022. Lisbon. Retrieved from www.emcdda.europa.eu/data/stats2022_en.
  27. Fernández-Serrano M.J., Pérez-García M., Perales J.C., Verdejo-García A. (2010). Prevalence of executive dysfunction in cocaine, heroin and alcohol users enrolled in therapeutic communities. European Journal of Pharmacology, 626(1): 104-112. DOI: 10.1016/j.ejphar.2009.10.019.
  28. Fernández-Serrano M.J., Pérez-García M., Verdejo-García A. (2011). What are the specific vs. generalized effects of drugs of abuse on neuropsychological performance? Neuroscience and Biobehavioral Reviews, 35(3): 377-406. DOI: 10.1016/j.neubiorev.2010.04.008.
  29. Folstein M.F., Folstein S.E., McHugh P.R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3): 189-198. DOI: 10.1016/0022-3956(75)90026-6.
  30. Goldstein R.Z., Craig A.D.B., Bechara A., Garavan H., Childress A.R., Paulus M.P., Volkow N.D. (2009). The neurocircuitry of impaired insight in drug addiction. Trends in Cognitive Sciences, 13(9): 372-380. DOI: 10.1016/j.tics.2009.06.004.
  31. Goldstein R.Z., Volkow N.D. (2011). Dysfunction of the prefrontal cortex in addiction: neuroimaging findings and clinical implications. Nature Reviews. Neuroscience, 12(11): 652-669. DOI: 10.1038/nrn3119.
  32. Goschke T. (2014). Dysfunctions of decision-making and cognitive control as transdiagnostic mechanisms of mental disorders: advances, gaps, and needs in current research. International Journal of Methods in Psychiatric Research, 23(S1): 41-57. DOI: 10.1002/mpr.1410.
  33. Grohman K., Fals-Stewart W. (2004). The detection of cognitive impairment among substance-abusing patients: the accuracy of the neuropsychological assessment battery-screening module. Experimental and Clinical Psychopharmacology, 12(3): 200-207. DOI: 10.1037/1064-1297.12.3.200.
  34. Ioannidis K., Hook R., Goudriaan A.E., Vlies S., Fineberg N.A., Grant J.E., Chamberlain S.R. (2019). Cognitive deficits in problematic internet use: meta-analysis of 40 studies. British Journal of Psychiatry, 215(5): 639-646. DOI: 10.1192/bjp.2019.3.
  35. Keefe R.S.E., Goldberg T.E., Harvey P.D., Gold J.M., Poe M.P., Coughenour L. (2004). The Brief Assessment of Cognition in Schizophrenia: reliability, sensitivity, and comparison with a standard neurocognitive battery. Schizophrenia Research, 68(2-3): 283-297. DOI: 10.1016/j.schres.2003.09.011.
  36. Koob G.F., Volkow N.D. (2016). Neurobiology of addiction: a neurocircuitry analysis. The Lancet Psychiatry, 3(8): 760-773. DOI: 10.1016/S2215-0366(16)00104-8.
  37. Kutlu M.G., Gould T.J. (2016). Effects of drugs of abuse on hippocampal plasticity and hippocampus-dependent learning and memory: contributions to development and maintenance of addiction. Learning and Memory, 23(10): 515-533. DOI: 10.1101/lm.042192.116.
  38. Maracic C.E., Moeller S.J. (2021). Neural and behavioral correlates of impaired insight and self-awareness in Substance Use Disorder. Current Behavioral Neuroscience Reports, 8(4): 113-123. DOI: 10.1007/s40473-021-00240-x.
  39. McTeague L.M., Goodkind M.S., Etkin A. (2016). Transdiagnostic impairment of cognitive control in mental illness. Journal of Psychiatric Research, 83: 37-46. DOI: 10.1016/j.jpsychires.2016.08.001.
  40. Menon V. (2011). Large-scale brain networks and psychopathology: a unifying triple network model. Trends in Cognitive Sciences, 15(10): 483-506. DOI: 10.1016/j.tics.2011.08.003.
  41. Millan M.J., Agid Y., Brüne M., Bullmore E.T., Carter C.S., Clayton N.S., … Young L.J. (2012). Cognitive dysfunction in psychiatric disorders: characteristics, causes and the quest for improved therapy. Nature Reviews Drug Discovery, 11(2): 141-168. DOI: 10.1038/nrd3628.
  42. Ministero della Salute (2022). Rapporto tossicodipendenze. Analisi dei dati del sistema Informativo Nazionale delle Dipendenze. Anno 2021.
  43. Nasreddine Z.S., Phillips N.A., Bédirian V., Charbonneau S., Whitehead V., Collin I., Cummings J.L., Chertkow H., Colllin I., Cummings J.L., Chertkow H. (2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4): 695-699. DOI: 10.1111/j.1532-5415.2005.53221.x.
  44. NIDA (2022). Sex and gender differences in substance use. North Bethesda, MD. Retrieved from https://nida.nih.gov/publications/research-reports/substance-use-in-women/sex-gender-differences-in-substance-use.
  45. Nolen-Hoeksema S., Watkins E.R. (2011). A heuristic for developing transdiagnostic models of psychopathology. Perspectives on Psychological Science, 6(6): 589-609. DOI: 10.1177/1745691611419672.
  46. Pagnoni I., Gobbi E., Alaimo C., Campana E., Rossi R., Manenti R., … Cotelli M. (2022). The relationship between theory of mind and executive functions in major depressive disorders: a review. Frontiers in Psychiatry, 13, 980392. DOI: 10.3389/fpsyt.2022.980392.
  47. Snyder H.R., Miyake A., Hankin B.L. (2015). Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches. Frontiers in Psychology, 6: 328. DOI: 10.3389/fpsyg.2015.00328.
  48. Solowij N., Michie P.T., Fox A.M. (1995). Differential impairments of selective attention due to frequency and duration of cannabis use. Biological Psychiatry, 37(10): 731-739. DOI: 10.1016/0006-3223(94)00178-6.
  49. Stevens L., Goudriaan A.E., Verdejo-García A., Dom G., Roeyers H., Vanderplasschen W. (2015). Impulsive choice predicts short-term relapse in substance-dependent individuals attending an in-patient detoxification programme. Psychological Medicine, 45(10): 2083-2093. DOI: 10.1017/S003329171500001X.
  50. Stevens L., Verdejo-García A., Goudriaan A.E., Roeyers H., Dom G., Vanderplasschen W. (2014). Impulsivity as a vulnerability factor for poor addiction treatment outcomes: a review of neurocognitive findings among individuals with substance use disorders. Journal of Substance Abuse Treatment, 47(1): 58-72. DOI: 10.1016/j.jsat.2014.01.008.
  51. van Timmeren T., Daams J.G., van Holst R.J., Goudriaan A.E. (2018). Compulsivity-related neurocognitive performance deficits in gambling disorder: a systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews, 84: 204-217. DOI: 10.1016/j.neubiorev.2017.11.022.
  52. Verdejo-García A., Bechara A., Recknor E.C., Pérez-García M. (2006). Executive dysfunction in substance dependent individuals during drug use and abstinence: an examination of the behavioral, cognitive and emotional correlates of addiction. Journal of the International Neuropsychological Society, 12(3): 405-415. DOI: 10.1017/S1355617706060486.
  53. Verdejo-García A., Betanzos-Espinosa P., Lozano-Rojas O.M., Vergara-Moragues E., González-Saiz, Fernández-Calderón F., … Pérez-García M. (2012). Self-regulation and treatment retention in cocaine dependent individuals: a longitudinal study. Drug and Alcohol Dependence, 122(1-2): 142-148. DOI: 10.1016/j.drugalcdep.2011.09.025.
  54. Verdejo-García A., Lorenzetti V., Manning V., Piercy H., Bruno R., Hester R., … Ekhtiari H. (2019). A roadmap for integrating neuroscience into addiction treatment: a consensus of the Neuroscience Interest Group of the International Society of Addiction Medicine. Frontiers in Psychiatry, 10: 877. DOI: 10.3389/fpsyt.2019.00877.
  55. Waters A.J., Marhe R., Franken I.H.A. (2012). Attentional bias to drug cues is elevated before and during temptations to use heroin and cocaine. Psychopharmacology, 219(3): 909-921. DOI: 10.1007/s00213-011-2424-z.
  56. Yücel M., Lubman D.I., Solowij N., Brewer W.J. (2007). Understanding drug addiction: a neuropsychological perspective. Australian & New Zealand Journal of Psychiatry, 41(12): 957-968. DOI: 10.1080/00048670701689444.

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